Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
권호 표지
DOI QR코드

DOI QR Code

Unusual Isolated Complete Tear of Subscapularis and Biceps Long Head Tendon Associated with Heterotopic Ossification

  • Sohn, Hoon-Sang (Department of Orthopedic Surgery, Center for Joint Surgery, National Medical Center) ;
  • Baek, Duck In (Department of Orthopedic Surgery, Center for Joint Surgery, National Medical Center) ;
  • Shon, Min Soo (Department of Orthopedic Surgery, Center for Joint Surgery, National Medical Center)
  • Received : 2013.11.29
  • Accepted : 2014.04.22
  • Published : 2014.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Heterotopic ossification (HO) within the substance of the subscapularis tendon is a rare lesion which remains a poorly described condition with little known of the exact mechanisms involved. Furthermore, its clinical importance remains still unclear. To our knowledge, there are no studies present to data regarding HO within the substance of the subscapularis tendon, even with resultant isolated complete tear of the subscapularis tendon. Here we present a case of huge HO associated with unusual isolated complete tear of subscapularis tendon concomitant with tear of biceps long head tendon. After arthroscopic debridement for the complete tear site of biceps long head tendon, mini-open excision of the ossification and subscapularis repair with suture anchor fixation were performed. The patient showed complete recovery of strength and function of the subscapularis at subsequent 24 months follow up.

Keywords

References

  1. Fuller DA, Mani US, Keenan MA. Heterotopic ossification of the shoulder in patients with traumatic brain injury. J Shoulder Elbow Surg. 2013;22(1):52-6. https://doi.org/10.1016/j.jse.2012.01.028
  2. Pape HC, Marsh S, Morley JR, Krettek C, Giannoudis PV. Current concepts in the development of heterotopic ossification. J Bone Joint Surg Br. 2004;86(6):783-7. https://doi.org/10.1302/0301-620X.86B6.15356
  3. Arrigoni P, Brady PC, Burkhart SS. Calcific tendonitis of the subscapularis tendon causing subcoracoid stenosis and coracoid impingement. Arthroscopy. 2006;22(10):1139.e1-3.
  4. Busilacchi A, Bottegoni C, Gigante A. Arthroscopic management of heterotopic ossification of the subscapularis tendon in a patient with tuberculosis: a case report. J Shoulder Elbow Surg. 2012;21(1):e1-5. https://doi.org/10.1016/S1058-2746(12)00450-8
  5. Peidro L, Serra A, Suso S. Subcoracoid impingement after ossification of the subscapularis tendon. J Shoulder Elbow Surg. 1999;8(2):170-1. https://doi.org/10.1016/S1058-2746(99)90013-7
  6. Klasson SC, Vander Schilden JL, Park JP. Late effect of isolated avulsion fractures of the lesser tubercle of the humerus in children. Report of two cases. J Bone Joint Surg Am. 1993;75(11):1691-4. https://doi.org/10.2106/00004623-199311000-00015
  7. Goeminne S, Debeer P. The natural evolution of neglected lesser tuberosity fractures in skeletally immature patients. J Shoulder Elbow Surg. 2012;21(8):e6-e11. https://doi.org/10.1016/S1058-2746(12)00389-8
  8. Gerber C, Terrier F, Zehnder R, Ganz R. The subcoracoid space. An anatomic study. Clin Orthop Relat Res. 1987;(215):132-8.
  9. Richards DP, Burkhart SS, Campbell SE. Relation between narrowed coracohumeral distance and subscapularis tears. Arthroscopy. 2005;21(10):1223-8. https://doi.org/10.1016/j.arthro.2005.06.015
  10. Lafosse L, Jost B, Reiland Y, Audebert S, Toussaint B, Gobezie R. Structural integrity and clinical outcomes after arthroscopic repair of isolated subscapularis tears. J Bone Joint Surg Am. 2007;89(6):1184-93. https://doi.org/10.2106/00004623-200706000-00005
  11. Gerber C, Hersche O, Farron A. Isolated rupture of the subscapularis tendon. J Bone Joint Surg Am. 1996;78(7):1015-23. https://doi.org/10.2106/00004623-199607000-00005