Warner J J, McMahon P J
Department of Orthopaedic Surgery, University of Pittsburgh, Pennsylvania 15213.
J Bone Joint Surg Am. 1995 Mar;77(3):366-72. doi: 10.2106/00004623-199503000-00006.
We studied seven patients who had isolated loss of the proximal attachment of the tendon of the long head of the biceps brachii, documented operatively or with magnetic resonance imaging, in order to identify and measure superior translation of the humeral head on the glenoid. Four true anteroposterior radiographs were made of both shoulders, before and after the operation, with 0, 45, 90, and 120 degrees of humeral abduction in the scapular plane. Four patients were managed with arthroscopic acromioplasty with an open biceps tenodesis; one, with open biceps tenodesis alone; and one, with debridement of a ruptured biceps stump; the remaining patient was managed non-operatively. Two to six millimeters of superior translation of the humeral head was noted in each patient in all positions of humeral abduction except 0 degrees. This translation was significant compared with the contralateral (control) shoulder. Kappa statistical analysis showed excellent reproducibility and interobserver reliability of the technique of radiographic measurement. The results of this study support the role of the tendon of the long head of the biceps brachii as a stabilizer of the humeral head in the glenoid during abduction of the shoulder in the scapular plane.
我们研究了7例肱二头肌长头肌腱近端附着点孤立性缺失的患者，这些患者的情况通过手术或磁共振成像得以记录，目的是识别和测量肩胛平面内肱骨头在关节盂上的向上移位。在手术前后，分别对双肩拍摄四张真正的前后位X线片，拍摄时肱骨在肩胛平面内分别外展0°、45°、90°和120°。4例患者接受了关节镜下肩峰成形术加开放性肱二头肌肌腱固定术；1例仅接受开放性肱二头肌肌腱固定术；1例接受肱二头肌残端清创术；其余1例患者接受非手术治疗。除0°外，在肱骨外展的所有位置上，每例患者均观察到肱骨头向上移位2至6毫米。与对侧（对照）肩相比，这种移位具有显著性。Kappa统计分析表明，X线测量技术具有良好的可重复性和观察者间可靠性。本研究结果支持肱二头肌长头肌腱在肩胛平面内肩关节外展时作为肱骨头在关节盂内稳定器的作用。
