Braun S, Imhoff A B
Gelenkpunkt - Sport- und Gelenkchirurgie Innsbruck, Olympiastraße 39, 6020, Innsbruck, Österreich.
Sportorthopädie, TU München, Ismaninger Str. 22, 81675, München, Deutschland.
Orthopade. 2018 Feb;47(2):113-120. doi: 10.1007/s00132-017-3514-3.
The long head of the biceps and the biceps pulley sling are prone to acute or degenerative injury. As they both were identified as major pain generators, adequate diagnosis and treatment is vital for successful treatment of shoulder pain. Although the basic principles to address either pathology have not changed over the last decades, new trends have evolved to simplify surgical options. SLAP (superior labral tear from anterior to posterior) repair is seen more restrictive and is mostly performed in young individuals, whereas tenotomy or tenodesis are more often used in patients over 30. The long head of the biceps and pulley lesions are treated with either tenotomy or tenodesis. Surgical techniques for tenodesis are especially less invasive using current implants. Tenodesis is performed either intraarticular, supra- or subpectoral with tenodesis screws or suture anchors. Soft tissue tenodesis has become unpopular over the last decade. Surgical treatment of the long head of the biceps pathologies allows highly satisfying results if the indication is chosen thoroughly.
肱二头肌长头和肱二头肌滑车吊带容易发生急性或退行性损伤。由于它们都被确定为主要的疼痛产生源,因此进行充分的诊断和治疗对于成功治疗肩部疼痛至关重要。尽管在过去几十年中处理这两种病理情况的基本原则没有改变,但已经出现了简化手术选择的新趋势。SLAP(从前往后上盂唇撕裂)修复被认为限制更大,主要在年轻人中进行,而肌腱切断术或肌腱固定术在30岁以上的患者中更常用。肱二头肌长头和滑车损伤采用肌腱切断术或肌腱固定术治疗。使用当前的植入物,肌腱固定术的手术技术侵入性特别小。肌腱固定术可通过肌腱固定螺钉或缝合锚钉在关节内、胸大肌上或胸大肌下进行。在过去十年中,软组织肌腱固定术已不受欢迎。如果仔细选择适应症,肱二头肌长头病变的手术治疗可取得非常令人满意的结果。