Subscapularis minor – an analogue of the Teres minor?

SummaryIntroductionThe purpose of this study was to determine the role of the subscapularis (SSC) in forward flexion. We hypothesized that the inferior part of the SSC has a main role in the ability to preserve forward flexion in cases of anterosuperior rotator cuff tears.Material and methodsActive forward flexion of the shoulder was prospectively evaluated in patients presenting with Grade 3 or higher SSC fatty degeneration, with superior and inferior SSC tears being evaluated separately.ResultsThirty-two patients were enrolled in this study. Pseudoparalytic shoulders were found in 80% of cases when the inferior part of the SSC was torn, but never when only the superior part was torn.DiscussionThe inferior SSC or “Subscapularis minor” can be considered as an analogue to the teres minor in the posterior aspect of the shoulder. It must be preserved in cases of tears and fatty degeneration of the superior part, and repaired when possible.Level of evidenceLevel II.