Cho Chul-Hyun, Jung Gu-Hee, Song Kwang-Soon, Min Byung-Woo, Bae Ki-Cheor, Lee Kyung-Jae
Department of Orthopedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, Korea.
Orthopedics. 2010 Nov 2;33(11):849. doi: 10.3928/01477447-20100924-28.
Osteochondromas are one of the most common benign bone tumors. They usually arise from the metaphyses of long bones. Involvement of the bicipital tuberosity is rare. To date, no reports have described avulsed rupture of the distal biceps tendon caused by an osteochondroma of the bicipital tuberosity. This article presents a case of avulsion of the distal biceps tendon secondary to sessile osteochondroma of the bicipital tuberosity in a 65-year-old right-handed sedentary worker who presented with insidious pain and limited motion in his left elbow for 2 months. Intraoperative findings showed a bony mass of 25×23×5 mm with osteocartilaginous nodules on the bicipital tuberosity. The distal biceps tendon with an avulsed bony fragment was displaced proximally, with a 20-mm gap between the tendon and the bicipital tuberosity. After complete excision of the mass, footprint preparation at the bicipital tuberosity was performed using a 4.0-mm burr and anatomic reattachment of the distal biceps tendon with a 5.0-mm suture anchor. The pathologic diagnosis of osteochondroma was confirmed microscopically. We suggest that osteochondroma of the bicipital tuberosity be considered as a cause of painful limitation of forearm rotation or avulsed rupture of the distal biceps tendon.
骨软骨瘤是最常见的良性骨肿瘤之一。它们通常起源于长骨的干骺端。肱二头肌结节受累较为罕见。迄今为止,尚无关于肱二头肌结节骨软骨瘤导致肱二头肌远端肌腱撕脱断裂的报道。本文介绍了一例65岁右利手久坐工作者,因肱二头肌结节的无蒂骨软骨瘤继发肱二头肌远端肌腱撕脱,患者左肘隐匿性疼痛伴活动受限2个月。术中发现肱二头肌结节处有一个25×23×5mm的骨块,带有骨软骨结节。肱二头肌远端肌腱连同撕脱的骨块向近端移位,肌腱与肱二头肌结节之间有20mm的间隙。完整切除肿块后,用4.0mm的磨钻对肱二头肌结节进行骨床准备,并用5.0mm的缝合锚钉对肱二头肌远端肌腱进行解剖复位。骨软骨瘤的病理诊断经显微镜检查得以证实。我们建议,肱二头肌结节骨软骨瘤应被视为前臂旋转疼痛受限或肱二头肌远端肌腱撕脱断裂的一个原因。