Freiherr von Salis-Soglio G, Uhlig T
Klinik für Orthopädie, Medizinische Universität zu Lübeck.
Z Orthop Ihre Grenzgeb. 1988 Dec;126(6):683-7.
Injuries of M. biceps brachii are rare, in most cases (greater than 90%) the long tendon is involved, seldom the distal tendon. The long tendon usually ruptures in the sulcus intertubercularis, preexisting degenerative changes play an important role. The distal tendon most often ruptures traumatically at its radial insertion. Injuries of the short tendon do not require operative treatment, whereas complete ruptures of the venter of the muscle and of the distal tendon have to be operated on, in doing so the distal tendon should be reinserted at the radius. Ruptures of the long tendon may be treated conservatively, operation is indicated in young and active patients with painful functional lesion. In these cases proximal refixation under good tension should be realized. In accordance with bibliographical data our case material (11 operations) shows satisfying results in about 75%, though persistent pain or some functional lesion following operative treatment of ruptures of the long tendon has been observed in half of the patients. Finally general conclusions concerning indication and methods of operative treatment are made.
肱二头肌损伤很少见,多数情况下(超过90%)累及长头肌腱,远端肌腱损伤少见。长头肌腱通常在结节间沟处断裂,先前存在的退行性变起重要作用。远端肌腱最常于其桡侧止点处发生外伤性断裂。短头肌腱损伤无需手术治疗,而肌肉腹和远端肌腱的完全断裂则需手术治疗,手术时应将远端肌腱重新固定于桡骨。长头肌腱断裂可保守治疗,年轻且活动量大、有疼痛性功能障碍的患者则需手术治疗。在这些病例中,应在良好张力下进行近端重新固定。根据文献资料,我们的病例资料(11例手术)显示约75%的患者效果满意,不过,在一半的患者中,长头肌腱断裂手术治疗后仍有持续疼痛或一些功能障碍。最后得出了关于手术治疗适应证和方法的一般性结论。