Subpectoral tenodesis of the long head of the biceps tendon for pathologies of the long head of the biceps tendon and the biceps pulley.
Summary of "Subpectoral tenodesis of the long head of the biceps tendon for pathologies of the long head of the biceps tendon and the biceps pulley."
OBJECTIVE:
The presented surgical technique aims at fixation of the long head of the biceps tendon at the proximal humerus, distal to the bicipital groove, after arthroscopic tenotomy. This preserves the length and shape of the biceps muscle belly and avoids groove tenderness.
INDICATIONS:
All forms of degenerative changes of the long head of the biceps tendon, biceps instability due to pulley lesions, irreparable SLAP tears. The technique offers a cosmetically favorable outcome compared to a tenotomy.
CONTRAINDICATIONS:
Old complete tears of the long head of the biceps, significant loss of bone density due to osteoporosis, tumor or bone cysts, implants in the proximal humerus, such as intramedullary nails, stem of total shoulder replacement. The presented technique is not indicated for patients with unspecific chronic shoulder pain or if asymmetric shape of the upper arm due to distal migration of the biceps is not relevant. SURGICAL
TECHNIQUE:
After arthroscopic tenotomy of the long head of the biceps tendon, a small incision at the level of the pectoralis major tendon is made to the axillary fold. The stump of the long head of the biceps tendon is tenodesed to a predrilled hole with a bioabsorbable screw. POSTOPERATIVE
MANAGEMENT:
No active training of the biceps for 6 weeks, a sling for comfort is optional until healing of the wound is completed.
RESULTS:
Clinical studies of several authors have shown significant postoperative increase in all scores evaluated. Safety of the screw fixation and a low complication rate have been proven.
Affiliation
Abteilung für Sportorthopädie, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland, sepp.braun@lrz.tu-muenchen.de.
Journal Details
This article was published in the following journal.
Name: Operative Orthopadie und Traumatologie
ISSN: 1439-0981
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22805714
- DOI: http://dx.doi.org/10.1007/s00064-012-0178-3
Medical and Biotech [MESH] Definitions
Sphingolipids
A class of membrane lipids that have a polar head and two nonpolar tails. They are composed of one molecule of the long-chain amino alcohol sphingosine (4-sphingenine) or one of its derivatives, one molecule of a long-chain acid, a polar head alcohol and sometimes phosphoric acid in diester linkage at the polar head group. (Lehninger et al, Principles of Biochemistry, 2nd ed)
Tenodesis
Fixation of the end of a tendon to a bone, often by suturing.
Epiphyses
The head of a long bone that is separated from the shaft by the epiphyseal plate until bone growth stops. At that time, the plate disappears and the head and shaft are united.
Penfluridol
One of the long-acting ANTIPSYCHOTIC AGENTS used for maintenance or long-term therapy of SCHIZOPHRENIA and other PSYCHOTIC DISORDERS.
Insurance, Long-term Care
Health insurance to provide full or partial coverage for long-term home care services or for long-term nursing care provided in a residential facility such as a nursing home.
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