Isolated and Combined Tears of the Subscapularis Tendon

Background Isolated and combined subscapularis tendon tears are rare and are described in the literature only in small numbers. Hypothesis The outcome of surgical intervention for isolated and combined subscapularis tendon tears may be influenced by the tear pattern of the anterior rotator cuff and the period of time between trauma and surgical procedure. Study Design Case series; Level of evidence, 4. Methods Between 1994 and 1999, 34 shoulders with isolated traumatic tears (16 shoulders) or subscapularis tendon rupture combined with a supraspinatus tendon tear were treated operatively. The average patient age was 51 years, and the mean follow-up period was 37 months. For statistical analyses, the Friedman and Mann-Whitney tests were used. Results In patients with isolated tears, the Constant score rose from an average of 43.9 to 88.7 points (P <. 01), and in patients with combined tears, it rose from an average of 40.6 to 74.7 points (P <. 01). Isolated tears improved 14 points more than combined tears (P <. 05). The delay between trauma and surgical intervention was inversely proportional to the improvement in the Constant score. The Spearman coefficient of correlation was -0.97 in isolated tears and -0.89 in combined tears. Conclusions Young patients with isolated traumatic tears of the subscapularis tendon and immediate repair have the best prognostic factors for treatment. Accuracy in the trauma history and the clinical and radiographic examination is demanded.