Sohn Hyuk-Joon, Cho Chul-Hyun, Kim Du-Han
Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, South Korea.
World J Clin Cases. 2023 Sep 16;11(26):6304-6310. doi: 10.12998/wjcc.v11.i26.6304.
Dislocation of the long head of biceps tendon (LHBT) usually involves rotator cuff injury, and isolated dislocation with an intact rotator cuff is rare. Some cases of isolated dislocation have been reported. However, to the best of our knowledge, there has been no report of bilateral dislocation of the LHBT without rotator cuff pathology.
A 23-year-old male presented to our outpatient clinic with left side dominant pain in both shoulders. The patient had no history of trauma or overuse. The patient underwent intra-articular injection and physical therapy, but his symptoms aggravated. Based on preoperative imaging, the diagnosis was bilateral dislocation of the LHBT. Dysplasia of the bicipital groove was detected in both shoulders. Active dislocation of the biceps tendon over an intact subscapularis tendon was identified by diagnostic arthroscopy. Staged biceps tenodesis was performed and continuous passive motion therapy was administered immediately after surgery. The patient's pain was resolved, and full functional recovery was achieved, and he was satisfied with the condition of his shoulders.
This study describes a rare case of bilateral dislocations of the LHBT without rotator cuff injury due to dysplasia of the bicipital groove.
肱二头肌长头肌腱(LHBT)脱位通常伴有肩袖损伤,孤立性脱位且肩袖完整的情况罕见。已有一些孤立性脱位病例的报道。然而,据我们所知,尚无肱二头肌长头肌腱双侧脱位且无肩袖病变的报道。
一名23岁男性因双肩左侧为主的疼痛前来我院门诊就诊。患者无外伤或过度使用史。患者接受了关节内注射和物理治疗,但其症状加重。根据术前影像学检查,诊断为双侧肱二头肌长头肌腱脱位。双侧均检测到肱二头肌沟发育异常。通过诊断性关节镜检查发现肱二头肌肌腱在完整的肩胛下肌腱上主动脱位。分期进行了肱二头肌肌腱固定术,并在术后立即给予持续被动运动治疗。患者疼痛缓解,功能完全恢复,对肩部状况满意。
本研究描述了一例因肱二头肌沟发育异常导致的双侧肱二头肌长头肌腱脱位且无肩袖损伤的罕见病例。