Loitz D, Klonz A
Klinik für Unfallchirurgie und Orthopädische Chirurgie, Klinikum Salzgitter, Kattowitzer Strasse 191, Salzgitter, Germany.
Unfallchirurg. 2011 Jan;114(1):47-53; quiz 54. doi: 10.1007/s00113-010-1897-2.
The biceps muscle of the arm is even well known to laymen because of its partially prominent appearance. It fulfills a very important function in the arm due to its capacity for flexion and supination. Lesions of the short proximal biceps tendon are a rare occurrence. The long biceps tendon that runs through the glenohumeral joint is a frequent source of pain. Tenotomy with or without tenodesis is often a judicious treatment approach. Spontaneous ruptures due to underlying degenerative changes are also frequently observed. The resultant loss of strength in forearm flexion and supination is however fairly minor so that surgical management is only sensibly indicated for cosmetic reasons. The frequent underlying lesions of the supraspinatus and/or subscapularis tendons should be addressed as these represent significant associated pathological conditions. Complete rupture of the distal biceps tendon is typically seen in physically active men. Loss of strength after conservative therapy is extensive (30-40% for flexion and >50% for supination). Fixation of the tendon at the radial tuberosity holds out the prospect of good functional outcome. Chronic partial lesions of the distal biceps tendon can be particularly painful and have to be considered in the differential diagnosis of elbow pain.