A Novel Treatment for a Rare Injury: Pediatric Massive Intrasubstance Rotator Cuff and Periscapular Muscle Tears Treated with a Custom Brace: A Case Report.

CASE: A 9-year-old boy sustained intrasubstance tears of the rotator cuff and periscapular muscles due to a fall, resulting in scapular winging and severely decreased shoulder range of motion. Treatment consisted of a modified thoracolumbosacral orthosis (TLSO) with a shoulder immobilizer attachment (to reduce the scapula to the thoracic wall and hold the arm in 10° of abduction). The brace was worn for 8 weeks. The patient recovered full, pain-free shoulder function and range of motion, and returned to high-level athletics.

CONCLUSION: Pediatric massive intrasubstance rotator cuff and periscapular muscle tears can be treated nonoperatively with use of a modified TLSO.