title: Rupture of the subscapularis tendon (isolated or in combination with supraspinatus tear): when is a repair indicated?
abstract: Ruptures of the subscapularis tendon, isolated or combined, are rare, and the treatment modalities are controversial. Of 1345 patients who underwent rotator cuff repair in a 7-year period, 73 had either an isolated rupture of the subscapularis or a subscapularis rupture combined with rupture of the supraspinatus. All reconstructions were performed through a deltopectoral approach. Reinsertion of the subscapularis was combined with reconstruction of the supraspinatus in 32 patients. Of the patients, 63 (86%) were re-examined at a mean follow-up of 35 months. The modified Constant score improved from 62% preoperatively to 91% at follow-up. Isolated or combined reconstructions did not result in significant differences with respect to the Constant score. Of the patients, 62 (98%) were satisfied with the operation. Rerupture was found by ultrasound in 8 subscapularis tendons (13%) and 4 supraspinatus tendons (13%). The rerupture rate showed a significant correlation with the Goutallier stage of fatty degeneration and the interval between injury and operation.
authors.affiliation: Orthopedics Department, Upper Extremity Unit, Schulthess Clinic, Zurich, Switzerland. matthias.flury@kws.ch <matthias.flury@kws.ch>
authors.forename: Matthias P
authors.initials: MP
authors.lastname: Flury
authors.forename: M
authors.initials: M
authors.lastname: John
authors.forename: J
authors.initials: J
authors.lastname: Goldhahn
authors.forename: H-K
authors.initials: HK
authors.lastname: Schwyzer
authors.forename: B R
authors.initials: BR
authors.lastname: Simmen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture; D013710:Tendons / Q000601:surgery