Working Diagnosis:
Full Thickness Supraspinatus Tear

Treatment:
Primary arthroscopic repair Case Photo #6 , Case Photo #7 , Case Photo #8 , Case Photo #9 with 6 month post-operative progressive rehabilitation.

Outcome:
Return to play without limitations at 6 months port-operatively.

Editor's Comments:
While supraspinatus tendon tears are common shoulder injuries in older athletes, they are very uncommon in younger athletes. Itoi and Tabata reported the incidence of rotator cuff tears in adolescents as 0.8% (3 of 379 tears). When they do occur in young athletes it is usually after trauma. As was the etiology in this case. The limited range of motion and significant weakness noted on exam point to a supraspinatus tendon tear. A drop arm test could also have been performed and would likely have been positive. Early identification and surgical intervention in young athletes with rotator cuff tears usually allows for excellent outcomes.

References:
1)Itoi E, and Tabata S: Rotator cuff tears in the adolescent, Orthopedics 1993; 16: pp. 78-81
2) Yamanaka K, and Matsumoto T: The joint side tear of the rotator cuff. A follow up study by arthrography. Clin Orthop Relat Res 1994; undefined: pp. 68-7
3) Patel P, and Warner JJ: Shoulder injuries in the skelatally immature athlete. Sports Med Arthrosc Rev 1996; 4: pp. 99-113.
4) Zbojniewicz AM, Maeder ME, Emery KH, Salisbury SR: Rotator cuff tears in children and adolescents: experience at a large pediatric hospital. Pediatr Radiol. 2014 Jun;44(6):729-37. doi: 10.1007/s00247-014-2875-6. Epub 2014 Jan 29.
5) Maxwell C Alley, BS; Samik Banerjee, MBBS, MS (Orth), MRCS (Glasg); Dean Papaliodis, MS; Konstantinos Tsitos; George S. Zanaros, MD: Transosseous Physeal-Sparing Rotator Cuff Repair in an Adolescent Football Player. Prthopedics. 2016; 39 (2): e353-3358..
6) McFarland EG, Hsu CY, Neira C, et al: Internal impingement of the shoulder: A clinical and arthroscopic analysis. J Shoulder Elbow Surg 1999; 8: pp. 458-460.

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