Complete traumatic rotator cuff tears in children and adolescents: a multicenter retrospective study

OBJECTIVES: Complete rotator cuff tears in adolescents that require surgery are exceptional. The purpose of this work was to analyze the medium- and long-term results in adolescents who underwent arthroscopic or open repair of a complete rotator cuff tear. METHODS: All surgeons who are members of the French Shoulder and Elbow Society (SOFEC) and the French Arthroscopy Society (SFA) were contacted. They were sent an electronic questionnaire asking whether they had had to surgically treat a traumatic complete rotator cuff tear in a child or adolescent. Of 233 surgeons, 90 responded to the questionnaire. Only 15 had actually had the opportunity to address one or more cases. Surgeons who responded positively to the questionnaire were contacted to retrieve complete medical data on their patient(s). RESULTS: Nineteen records were reviewed. The mean age at the time of surgery was 14.7 years (12-17). A frequent injury mechanism was glenohumeral dislocation during contact sports (n = 7/19). The subscapularis muscle was involved in 100% of the cases. In 31% of the cases, the injury also involved the supraspinatus and/or infraspinatus. Open (n = 6/19) or arthroscopic (n = 13/19) surgery was performed. At a mean follow-up of 47 months (24 months - 18 years), 79% had resumed sports at the previous level. Two patients had a neurological complication, one of whom required a nerve graft surgery. In 14% of the cases, pseudarthrosis of the lesser tuberosity occurred, and the surgical revision did not affect the final result. Only one patient had recurrent anterior instability requiring a bone block surgery seven years after the initial surgery. CONCLUSION: Complete rotator cuff tears are exceptional in adolescents. Injuries are mainly in the subscapularis. Reinsertion, even if it is late, ideally performed by arthroscopy, provides good results with resumption of sports at the previous level in 79% of the cases