Prabhu Jagadish, Faqi Mohammed Khalid, Awad Rashad Khamis, Alkhalifa Fahad
Bahrain Defence Force Hospital - Royal Medical Services, Riffa, Kingdom of Bahrain.
Open Orthop J. 2017 Mar 31;11:281-290. doi: 10.2174/1874325001711010281. eCollection 2017.
The vast majority of biceps tendon ruptures occurs at the proximal insertion and almost always involves the long head. There are several options for long head of biceps (LHB) tenodesis with advantage and disadvantages of each technique. We believe that the suprapectoral LHB tenodesis described in this article enables the restoration of the anatomic length-tension relation in a technically reproducible manner, when following the guidelines set forth in this article, and restores biceps contour and function adequately with a low risk of complications.
We present a case of a young man who had a sudden jerk of his flexed right elbow, while involved in water skiing sports and sustained complete rupture of proximal end of long head of biceps tendon. In this article, we describe a modified surgical technique of open supra-pectoral long head of biceps tenodesis using an EndoButton tension slide technique, reproducing an anatomic length-tension relationship.
By the end of one year, patient regained symmetrical muscle bulk, shape and contour of biceps compared to other side. There were no signs of dislodgement or loosening of the EndoButton on follow-up radiographs. He regained full muscle power in the biceps without any possible complications, such as humeral fracture, infection, or nerve injury, associated with this technique.
This technique is a safe, easy to reproduce, cost-effective, less time consuming and an effective method that uses a small drill hole, conserving bone, minimizing trauma to the tendon, and decreasing postoperative complications. It does not need any special instrumentation and is suitable especially for use in centers where arthroscopy facility or training is not available.
绝大多数肱二头肌肌腱断裂发生在近端附着点，且几乎均累及肱二头肌长头。肱二头肌长头（LHB）固定术有多种选择，每种技术都有其优缺点。我们认为，本文所述的胸上LHB固定术能够以技术上可重复的方式恢复解剖学长度 - 张力关系，前提是遵循本文所述的指导原则，并且能充分恢复肱二头肌轮廓和功能，并发症风险较低。
我们报告一例年轻男性病例，该患者在参与滑水运动时，屈曲的右肘突然猛拉，导致肱二头肌长头肌腱近端完全断裂。在本文中，我们描述了一种改良的开放性胸上肱二头肌长头固定术的手术技术，采用EndoButton张力滑动技术，重现解剖学长度 - 张力关系。
到一年结束时，与另一侧相比，患者肱二头肌的肌肉量、形状和轮廓恢复对称。随访X线片显示EndoButton没有移位或松动迹象。他的肱二头肌恢复了全部肌肉力量，且未出现与该技术相关的任何可能并发症，如肱骨骨折、感染或神经损伤。
该技术安全、易于重复、经济有效、耗时少，是一种有效的方法，使用小钻孔，保留骨质，减少对肌腱的创伤，降低术后并发症。它不需要任何特殊器械，特别适用于没有关节镜设备或培训的中心。
