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Discipline Track

Clinical Science

Abstract

Background: 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.

Methods: 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 patientsdemographics, mechanism, injury type and injury location were recorded. Treatment type and patient outcomes were abstracted when available and summarized with descriptive statistics.

Results: Our search identified 28 studies published from 1994-2020 which included 215 total tendons injured in 185 patients. Twenty-six studies were classified as Level IV evidence while only two were Level III. When described, the most injured tendon (n=184) was the supraspinatus while 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 8 studies included Patient Reported Outcome Measures (PROMs) and just 5 had pre- and post-treatment scores. Three complications were noted, all in operative patients.

Conclusion: 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.

Presentation Type

Poster

Academic Level

Medical Student

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Rotator cuff injury in the pediatric population: a systematic review of patient characteristics, treatment, and outcomes

Background: 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.

Methods: 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 patientsdemographics, mechanism, injury type and injury location were recorded. Treatment type and patient outcomes were abstracted when available and summarized with descriptive statistics.

Results: Our search identified 28 studies published from 1994-2020 which included 215 total tendons injured in 185 patients. Twenty-six studies were classified as Level IV evidence while only two were Level III. When described, the most injured tendon (n=184) was the supraspinatus while 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 8 studies included Patient Reported Outcome Measures (PROMs) and just 5 had pre- and post-treatment scores. Three complications were noted, all in operative patients.

Conclusion: 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.

 

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