- See:
-
Biceps Tendonitis
-
SLAP Lesions
- Discussion:
- this tendon may have some role as a depressor of humeral head, preventing superior
migration of humeral head;
- approx 50% of all ruptures occur thru the tendon of the long head;
- rupture is usually is usually more or less transverse and is located either w/in
shoulder joint or within the proximal part of intertubercular groove;
- Clinical Findings:
- bunching up of
biceps muscle in distal arm, (which does not go away);
- there is minimal loss of function because short head of
biceps remains
attached to the coracoid process;
- MRI:
- will show absence of the tendon in the bicipital groove;
- Non Operative Treatment:
- patients can be treated non operatively since most will become asymptomatic
after 4-6 weeks;
- Operative Treatment:
- may be indicated for cosmesis or if shoulder reconstruction is required for other reasons;
- patients can expect only a small increase in flexion strength (10%);
- surgical treatment involves then excision of the intraarticular part of tendon, & fixation of
remaining tendon to bicipital groove or into the coracoid process;
- fixation to the bicipital groove is performed using "key hole technique":
- a narrow slit is cut into the bone, just underneath a larger drill hole;
- the biceps tendon is passed into the drill hole and is then allowed to to wedge down into the slit;
- the main difficulty with this procedure is obtaining proper tension on the muscle tendon unit;
The role of the long head of the biceps brachi in superior stability of the glenohumeral joint.
Ultrasonographic evaluation of the rotator cuff and biceps tendon.
Tenodesis of the long head of the biceps brachi for chronic bicipital Tendinitis. Long-term results.
Rupture of the tendon of the long head of the biceps brachi. Surgical versus nonsurgical treatment.
Treatment of ruptures of the long head of the biceps brachii. R Soto-Hall and JH Stroot.
Am J. Orthop. Vol 2 1960. p 192.
Isolated Arthroscopic Biceps Tenotomy or Tenodesis Improves Symptoms in Patients with Massive Irreparable Rotator Cuff Tears.
