[Functional results after suture repair in ruptures of the long biceps tendon with special consideration of subacromial impingement].
Operative treatment for ruptures of the long biceps tendon still is discussed controversially. In the present literature the keyhole-technique is recommended according to favourable biomechanical conditions. In recent years refixation to the short biceps tendon was preferred. Now it is supposed that this technique may provoke subacromial impingement considering the loss of depression function of the long biceps tendon to the humeral head. Between 1980 to 1991 83 patients with rupture of the long biceps tendon were treated operatively by refixation to the short head. 28 patients were investigated after an average follow-up of 6.5 years. Due to the criteria of the Constant-Score 85% of patients achieved very good, 15% good results. At our patients provocation of a subacromial impingement could not be observed. The subacromial space was not reduced in the postoperative x-ray control. Compared with the non-operated shoulder isokinetic determination of isometric maximal peak torque for elbow-flexion, shoulder-abduction and shoulder-flexion yield to almost identical results for the operated shoulder. Refixation to the short head can be advised for treatment of ruptures of the long biceps tendon due to the certain technique with a low complication rate and very good functional outcome.
Ambacher
T
T
Chirurgische Universitätsklinik, BG-Kliniken Bergmannsheil Bochum. tambacher@t-online.de
Winter
E
E
Piert
M
M
Mayer
F
F
Weise
K
K
D000328:Adult; D000368:Aged; D001134:Arm Injuries / Q000601:surgery*; D001696:Biomechanical Phenomena; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007537:Isometric Contraction; D008297:Male; D008875:Middle Aged; D012421:Rupture; D019534:Shoulder Impingement Syndrome / Q000175:diagnosis / Q000209:etiology*; D013537:Sutures; D013708:Tendon Injuries / Q000601:surgery*; D013997:Time Factors; D019415:Torque