Abstract:Subscapularis tendon tears in the pediatric population are most commonly associated with an avulsion fracture of the lesser tuberosity. Isolated subscapularis tendon ruptures are infrequently reported. According to previous reports, the diagnosis of subscapularis tendon injuries in pediatric patients is often delayed and management is typically conservative. When operative management is indicated, an open deltopectoral approach has been used and may include concomitant open reduction and internal fixation of t… Show more
“…This left 21 studies published in English between 1993 and 2020 that were included for analysis. 5,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]…”
Section: Prisma Search Resultsmentioning
confidence: 99%
“…This left 21 studies published in English between 1993 and 2020 that were included for analysis. 5 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 Fig 1 Flowchart of study screening and selection in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. …”
Section: Resultsmentioning
confidence: 99%
“… 23 Nine articles were assessed to have moderate quality and risk of bias, 24 , 27 , 28 , 29 , 31 , 32 , 35 , 37 , 39 and 11 were assessed to have low quality and, therefore, high risk of bias. 5 , 21 , 22 , 25 , 26 , 30 , 33 , 34 , 36 , 38 , 40 …”
Section: Resultsmentioning
confidence: 99%
“…Only one included study was assessed to have good quality and, therefore, low risk of bias as per the Methodological Quality and Synthesis of Case Series and Case Reports framework proposed by Murad et al 23 Nine articles were assessed to have moderate quality and risk of bias, 24,[27][28][29]31,32,35,37,39 and 11 were assessed to have low quality and, therefore, high risk of bias. 5,21,22,25,26,30,33,34,36,38,40…”
“…Is the case(s) described with sufficient details to allow other investigators to replicate the research or to allow practitioners make inferences related to their own practice? Overall Quality Assessment Agarwalla et al., 2020 21 no yes yes n/a n/a n/a no yes Low Alley et al., 2016 22 no yes yes n/a n/a n/a no yes Low Azzam et al. 2018 23 yes yes yes n/a n/a n/a yes yes Good Banerjee et al., 2012 24 no yes yes n/a n/a n/a yes yes Moderate Battaglia et al., 2003 25 no yes yes n/a n/a n/a no yes Low Bhalla et al., 2011 26 no yes no n/a n/a n/a no …”
To systematically review the literature to determine the injury mechanisms, presentation, and timing of diagnosis for pediatric patients with intratendinous rotator cuff tears and to determine the efficacy of surgical intervention for affected patients. Methods: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus were searched. Studies were included if they involved only pediatric patients, soft-tissue rotator cuff injuries managed surgically, and reported outcomes. Patient characteristics, injury mechanisms, physical examination and imaging findings, time to diagnosis, surgical technique, and treatment outcomes were extracted. Findings were descriptively analyzed with weighted means and proportions. Results: Twenty-one studies comprising 78 patients were included. The age range was 8 to 17 years and 57 were male. The supraspinatus (n ¼ 56) was the most injured tendon. American football was the most reported sport played at the time of injury. Most patients were diagnosed within 6 months of injury via magnetic resonance imaging. Arthroscopic management was undertaken in 68 patients. Forty-six of 51 patients for whom data were available returned to sports at a range of 2.5 to 12 months postoperatively. Repair failure occurred in three patients. Conclusion: The extant literature regarding rotator cuff tears in pediatric patients is limited to reports of low methodological quality. Qualitative synthesis of this low-level literature reveals that rotator cuff tears are mostly reported in male collision sport athletes but may also occur in female athletes and/or throwing athletes. These injuries are often successfully managed via arthroscopic repair, and patients and their families can be reassured that the majority of patients return to sports following surgery.
“…This left 21 studies published in English between 1993 and 2020 that were included for analysis. 5,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]…”
Section: Prisma Search Resultsmentioning
confidence: 99%
“…This left 21 studies published in English between 1993 and 2020 that were included for analysis. 5 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 Fig 1 Flowchart of study screening and selection in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. …”
Section: Resultsmentioning
confidence: 99%
“… 23 Nine articles were assessed to have moderate quality and risk of bias, 24 , 27 , 28 , 29 , 31 , 32 , 35 , 37 , 39 and 11 were assessed to have low quality and, therefore, high risk of bias. 5 , 21 , 22 , 25 , 26 , 30 , 33 , 34 , 36 , 38 , 40 …”
Section: Resultsmentioning
confidence: 99%
“…Only one included study was assessed to have good quality and, therefore, low risk of bias as per the Methodological Quality and Synthesis of Case Series and Case Reports framework proposed by Murad et al 23 Nine articles were assessed to have moderate quality and risk of bias, 24,[27][28][29]31,32,35,37,39 and 11 were assessed to have low quality and, therefore, high risk of bias. 5,21,22,25,26,30,33,34,36,38,40…”
“…Is the case(s) described with sufficient details to allow other investigators to replicate the research or to allow practitioners make inferences related to their own practice? Overall Quality Assessment Agarwalla et al., 2020 21 no yes yes n/a n/a n/a no yes Low Alley et al., 2016 22 no yes yes n/a n/a n/a no yes Low Azzam et al. 2018 23 yes yes yes n/a n/a n/a yes yes Good Banerjee et al., 2012 24 no yes yes n/a n/a n/a yes yes Moderate Battaglia et al., 2003 25 no yes yes n/a n/a n/a no yes Low Bhalla et al., 2011 26 no yes no n/a n/a n/a no …”
To systematically review the literature to determine the injury mechanisms, presentation, and timing of diagnosis for pediatric patients with intratendinous rotator cuff tears and to determine the efficacy of surgical intervention for affected patients. Methods: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus were searched. Studies were included if they involved only pediatric patients, soft-tissue rotator cuff injuries managed surgically, and reported outcomes. Patient characteristics, injury mechanisms, physical examination and imaging findings, time to diagnosis, surgical technique, and treatment outcomes were extracted. Findings were descriptively analyzed with weighted means and proportions. Results: Twenty-one studies comprising 78 patients were included. The age range was 8 to 17 years and 57 were male. The supraspinatus (n ¼ 56) was the most injured tendon. American football was the most reported sport played at the time of injury. Most patients were diagnosed within 6 months of injury via magnetic resonance imaging. Arthroscopic management was undertaken in 68 patients. Forty-six of 51 patients for whom data were available returned to sports at a range of 2.5 to 12 months postoperatively. Repair failure occurred in three patients. Conclusion: The extant literature regarding rotator cuff tears in pediatric patients is limited to reports of low methodological quality. Qualitative synthesis of this low-level literature reveals that rotator cuff tears are mostly reported in male collision sport athletes but may also occur in female athletes and/or throwing athletes. These injuries are often successfully managed via arthroscopic repair, and patients and their families can be reassured that the majority of patients return to sports following surgery.
Rotator cuff injuries (RCIs), traditionally thought to be an adult-type pathology, have been reported in the pediatric population, but there remains limited evidence regarding this injury pattern in pediatric patients. The purpose of this study was to systematically review the literature to characterize the epidemiology, injury patterns, treatment modalities, and outcomes for pediatric patients with RCIs. A systematic review was performed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, reviewing Pubmed, Embase, Cochrane, and CINAHL databases. Studies reporting imaging confirmed RCIs, and treatment outcomes in patients less than 18 years of age were included. Patient demographics, mechanism, injury type, and injury location were recorded. Treatment type and patient outcomes were abstracted when available and summarized with descriptive statistics. Our search identified 28 studies published from 1994 to 2020, which included 215 total tendons injured in 185 patients. Twenty-six studies were classified as level IV evidence, whereas only two were level III. When described, the most injured tendon (n = 184) was the supraspinatus, whereas the most described injury type (n = 215) was a partial tear. Surgical intervention was pursued in 75.8% of injuries, with arthroscopy being more common than open repair (79.4% vs. 20.6%). Nonoperative treatment was primarily utilized for partial tears. Among the 24 studies reporting on return to sports, nonoperatively managed patients returned later than those treated operatively (mean: 10.7 vs. 7 months). Only eight studies included patient reported outcome measures (PROMs), and just five had pre- and posttreatment scores. Three complications were noted, all in operative patients. RCIs in pediatric patients have been reported in the literature with increasing frequency over the last decade, but the quality of evidence remains poor with inconsistent injury descriptions and outcome reporting. Excellent results were seen for all injury types and locations with both operative and nonoperative treatments. The literature for pediatric RCIs remains limited in guiding management decisions indicating a need for more high-quality studies to compare outcomes across injury and treatment type. Level of evidence: level III.
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