Lesser Tuberosity Avulsions in Adolescents

Lorenzo Nardo, Benjamin C. Ma, Lynne S. Steinbach

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Conclusion: Clinicians should have a high index of suspicion of lesser tuberosity avulsions in adolescents who present with loss of internal rotation and anterior shoulder pain following traumatic injuries. In addition, an osseous fragment or exostosis along the inferomedial humeral head should suggest a subscapularis tendon avulsion and also should not be confused with an osteochondroma or a neoplastic process.

Results: Two of the six patients had a large avulsion that simulated an exostosis of the proximal humerus that was misdiagnosed as an osteochondroma at two different outside institutions. All six cases were diagnosed with subscapularis tendon avulsion of the lesser tuberosity following clinical and imaging evaluation at our institution. Five of the patients underwent surgical repair and fixation of the tendon and the lesser tuberosity with suture anchors. One patient was treated conservatively. All patients had a good outcome with recovery of full shoulder strength and motion upon follow-up.

Background: Subscapularis tendon avulsions of the lesser tuberosity are relatively rare and often missed acutely and their characteristic appearance is frequently not recognized or is misinterpreted for an osteochondroma or a neoplastic process.

Questions/Purposes: This report reviews our experience with six adolescents who had subscapularis tendon avulsions of the lesser tuberosity.

Methods: Six male adolescents (12–15 years) presented with shoulder pain following history of trauma during amateur sport. Clinical notes including range of motion, strength tests, and pain assessment were reviewed along with imaging studies pre- and post treatment. Treatment consisted of either surgical or conservative measures.

Original languageEnglish (US)
Pages (from-to)201-207
Number of pages7
JournalHSS Journal
Volume10
Issue number3
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Rotator Cuff
Tendons
Osteochondroma
Exostoses
Neoplastic Processes
Shoulder Pain
Suture Anchors
Humeral Head
Humerus
Wounds and Injuries
Pain Measurement
Articular Range of Motion
Diagnostic Errors
Sports
Therapeutics

Keywords

  • MRI
  • rotator cuff
  • shoulder
  • subscapularis
  • trauma

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Lesser Tuberosity Avulsions in Adolescents. / Nardo, Lorenzo; Ma, Benjamin C.; Steinbach, Lynne S.

In: HSS Journal, Vol. 10, No. 3, 01.01.2014, p. 201-207.

Research output: Contribution to journalArticle

Nardo, Lorenzo ; Ma, Benjamin C. ; Steinbach, Lynne S. / Lesser Tuberosity Avulsions in Adolescents. In: HSS Journal. 2014 ; Vol. 10, No. 3. pp. 201-207.
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