Diagnosis of an isolated rupture of the sabscapularis tendon is difficult because it is rare. The purpose of this study was to suppose the pathogensis and to clarify the clinical features of this injurt.
This subject consisted of 16 cases confirmed by surgery. We divided these cases into two groups. One is the complete tear of the subscapularis tendon fromthe lesser tuberosity (n=11) and the otheris partial tear near the bicipital groove (n=5). We investigated the causes of this injury, the tenderness points, the usefulness of the Lift off test, the period to the operation, the clinical results and the conditions of the bicipital long tendon (LHB). In addition, we compared the two groups and investigated the tendency.
All of the patients had a definite history of trauma to an affected shoulder, but there is no tendercy about the causes of this injury. Majority had tenderness on the lesser tuberosity and the bicipital groove. The Lift off test was positive in all cases of the complete tear group, while in two cases (40%) of the partial tear group. There were some remarkable changes on the LHB in 14 cases (87%), 12cases of which were dislocation or subluxation from the bicipital groove, 2cases of which were inframmatory change. These disturbed LHB distuebed LHB were treated by only reduction in 5 cases, tenodesis to the intertubercular groove in 3 cases, transfer to the conjoined tendon in 4 cases. The average JOA score at follow up was 92 (78∼100).
[Conclusion] An isolated sabscapularis tendon rupture often involved the failure of LHB gliding mechanism. This injury shouid be treated operativery, because it was difficult to be treated conservatively.
