Review Question - QID 6637

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Rotator Cuff Tears QID: 6637 (SAE08UE.75)

QID 6637 (Type "6637" in App Search)

A 55-year-old man who works as a carpenter reports chronic right anterior shoulder pain and weakness. Examination reveals 90 degrees of external rotation (with the arm at the side) compared to 45 degrees on the left side. His lift-off examination is positive, along with a positive belly press finding. An MRI scan reveals a chronic, retracted atrophied subscapularis tendon. What is the most appropriate management of his shoulder pain and weakness?

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Shoulder fusion

5/425

Arthroscopic subscapularis repair

27/425

Intra-articular corticosteroid injection

12/425

Open subscapularis repair

24/425

Pectoralis major transfer

83%

352/425

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Chronic subscapularis tendon ruptures preclude primary repair. In such instances, subcoracoid pectoralis major tendon transfers may improve function and diminish pain. The subcoracoid position of the transfer allows redirection of the pectoralis major in a direction recreating the vector of the subscapularis tendon. Shoulder fusion is a salvage procedure, and corticosteroid injection may reduce pain but will not improve function.