Methodist Sports Medicine, Indianapolis, IN, USA.
Methodist Sports Medicine, Indianapolis, IN, USA.
J Shoulder Elbow Surg. 2014 Jul;23(7):919-23. doi: 10.1016/j.jse.2014.01.053. Epub 2014 Mar 26.
Lateral antebrachial cutaneous (LABC) nerve compression is a rare but debilitating injury. There are limited data on the association of LABC nerve compression and proximal biceps rupture. We theorized that because of distal migration, the biceps muscle and tendon cause compression on the nerve.
We present 2 cases in which patients had proximal biceps ruptures with tendon retraction and developed neurologic symptoms associated with the LABC nerve. To demonstrate our theory, we performed a cadaveric experiment. After making an incision to expose the entire biceps muscle and the musculocutaneous nerve and its branch into the LABC nerve, we marked each structure in 2-cm increments with a marking pen. The long head of the biceps was then cut to simulate a proximal biceps rupture.
The relationship between the 3 structures was then studied, showing no change in position of the musculocutaneous nerve or LABC nerve. The biceps muscle and tendon had migrated distally toward the LABC nerve, demonstrating compression of the nerve.
Proximal biceps tears commonly occur from trauma as well as iatrogenically after a biceps tenotomy for treatment of biceps tendinopathy. However, it is unusual for neuropathy of the LABC nerve to occur. Patients who develop neuropathy associated with the LABC nerve after a proximal biceps rupture can be effectively treated with LABC nerve decompression and biceps plasty. We found that this was an effective surgical treatment of LABC neuropathy without the need for proximal biceps tenodesis.
前臂外侧皮神经（LABC）受压是一种罕见但使人虚弱的损伤。关于 LABC 神经受压与肱二头肌近端断裂的相关性，数据有限。我们推测，由于远移，二头肌肌肉和肌腱对神经造成压迫。
我们报告了 2 例患者，他们均有近端肱二头肌断裂伴肌腱回缩，并出现与 LABC 神经相关的神经症状。为了验证我们的理论，我们进行了尸体实验。在切开暴露整个二头肌肌肉和肌皮神经及其分支到 LABC 神经后，我们用标记笔以 2 厘米的增量标记每个结构。然后切断二头肌长头以模拟近端肱二头肌断裂。
然后研究了这 3 个结构之间的关系，发现肌皮神经或 LABC 神经的位置没有变化。二头肌肌肉和肌腱已经向 LABC 神经远侧迁移，表现出对神经的压迫。
近端肱二头肌撕裂通常由创伤引起，也可在肱二头肌肌腱病治疗中进行肱二头肌肌腱切断后发生医源性撕裂。然而，LABC 神经神经病并不常见。近端肱二头肌断裂后出现 LABC 神经神经病的患者可通过 LABC 神经减压和二头肌成形术有效治疗。我们发现，这是一种有效的 LABC 神经病手术治疗方法，无需进行近端肱二头肌肌腱固定术。
