Avulsion of subscapularis muscle tendon leading to recurrent anterior dislocation of the shoulder
Abstract
Fifteen
patients,
ten
males
and
five
females,
were
identified
as
having
recurrent
anterior
dislocation
of
the
shoulder after trauma
due to
avulsion
of
the
subscapularis
muscle
tendon
from
its
humeral
attachment.
The
usual
mechanism
of
injury
was
traumatic
hyperextension
or
external
rotation
of
the
abducted
arm. The
right
arm
was involved
in
12
patients
and
the
left
arm
in
only three
patients.
The
presenting
symptoms were pain and
weakness of
the
affected
shoulder.
Physical
examination
showed reduction
of
the
passive
range
of
joint
movement
and
tenderness
on the
anterior
aspect
at
the
shoulder
at
the
level
of
the
intertubercular
groove
and a
reduced
range
of
internal
rotation
of
the
shoulder.
The
diagnosis
was
suspected
from
the
history,
physical
examination
and
radiographs and
was
finally
confirmed by surgical exploration.
The
ages
of
the
patients ranged from
20
to
46
years
(mean
33
years).
The
dislocation
was
found
to be
due
to
a
complete
tear
of
the
subscapularis
tendon
(12
patients) and partial
tears
in
three patients, without fracture
of
the
lesser
tuberosity
in
any
of
the
patients.
The
repair consisted
of
mobilisation
of
the
subscapularis
muscle
and
its reinsertion
into
an
osseous
trough created
in
the
humerus.
The
shoulder
was
splinted
for
six
weeks
in
a Velpenu
bandage
before
mobilisation
and
physiotherapy.
In
two
patients
the
subscapularis tendon
was
frayed
and
could
not
take
sutures and therefore
an
allograft
of
tendo
Achilles was
used.
The
patients
have
been
followed
up
for
an
average
of
three
years
postoperatively.
All
have
acceptable
functional
results but
a
reduced
range
of
external
rotation.
URI
http://www.bioline.org.br/pdf?js99027http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/28183
Citation
East and Central African Journal of Surgery, Volume 4, Issue 4, p.35-38, (1999)Publisher
University of Nairobi Department of Orthopaedic Surgery
Collections
- Faculty of Health Sciences (FHS) [10378]