Salmons Harold I, Warrender William J, Smith Shelby, Kearns Kenneth A, Strohl Adam
Department of Orthopaedics at Thomas Jefferson University, Philadelphia, PA (Mr. Salmons, Dr. Warrender, and Ms. Smith), and Philadelphia Hand to Shoulder Center, King of Prussia, PA (Dr. Kearns and Dr. Strohl).
J Am Acad Orthop Surg Glob Res Rev. 2019 Dec 11;3(12). doi: 10.5435/JAAOSGlobal-D-19-00074. eCollection 2019 Dec.
Traumatic intrasubstance ruptures of the biceps brachii are rare. Injury to its tendinous insertion or origin is most common. Isolated short head injuries are rare, and musculocutaneous nerve involvement has been reported for these injuries. We present a unique case report of a young, healthy man who sustained a symptomatic median and musculocutaneous nerve compression resulting from an intrasubstance tear of the short head of the biceps after a snow blower injury. Short belly rupture with injury-associated scar tissue compression of both the median and musculocutaneous nerves was identified in the operating room. Microsurgical decompression and tendon repair with a modified Mason-Allen configuration using 0-Vicryl suture were done. By 11 months postoperative, the patient experienced resolution of his arm pain, extension and flexion improvement from 0 to +140 to +15 to +150, elimination of the Tinel sign and of concomitant arm deformity, and improvement of elbow strength.
肱二头肌实质内创伤性断裂很少见。其肌腱附着点或起点损伤最为常见。孤立的肱二头肌短头损伤罕见，且有报道称这些损伤会累及肌皮神经。我们报告了一例独特病例，一名年轻健康男性在吹雪机损伤后，因肱二头肌短头实质内撕裂导致出现症状性正中神经和肌皮神经受压。术中发现短头肌腹断裂并伴有与损伤相关的瘢痕组织对正中神经和肌皮神经的压迫。采用0号薇乔缝线以改良的梅森 - 艾伦缝合法进行了显微手术减压和肌腱修复。术后11个月时，患者手臂疼痛消失，伸展和屈曲功能从0改善至 +140至 +15至 +150，Tinel征消失，手臂畸形消除，肘部力量增强。
