Traumatische Subskapularisruptur beim Jugendlichen

Within the last decade, subscapularis (SSC) tears have gained more attention as SSC insufficiency may lead to severe imbalance of the glenohumeral joint. The SSC is known to be the ventral aspect of the transverse force which is decisive for centering the glenohumeral joint. An isolated SSC tear is a relatively infrequent injury of the shoulder. In most cases, a traumatic etiology is reported, however, often combined with an injury of the pulley system or the long head of the biceps tendon.We report on a case of an adolescent suffering from an abduction and external rotational trauma of the shoulder. Clinical examination demonstrated positive SSC signs and magnetic resonance imaging (MRI) confirmed a complete SSC tear but absence of dislocation of the long biceps tendon. We performed an arthroscopic evaluation confirming the complete SSC rupture and repair was performed arthroscopically with a new double-row Speedbridge® technique (Arthrex®). The postoperative protocol included limitation of external rotation and abduction to 0° and 90° for 6 weeks, respectively. This regime can guarantee a tension-free tendon healing. Active motion in all planes was allowed 9 weeks postoperatively.