Injury of the Biceps Brachii Long Head Tendon

Pain and functional limitations of shoulder joint could be consequences of inflammation or an injury of biceps brachii long head tendon. Biceps tendon is well-known as a potential cause of shoulder pain for a long time. Pathological conditions include inflammation, degenerations of different stages, partial ruptures, dislocations and sub-dislocations. Nowadays there are many methods to treat the pathology of the biceps brachii long head tendon – from conservative management (blockades into the area of the tendon) at early stage of the disease and to surgical one, namely tenotomy (division of the tendon in place of attachment thereof) or tenodesis (division of the tendon with fixation thereof in other place).

Indications for surgery.

Pain in projection of the biceps brachii long head tendon, not cured by conservative means in 4-6 weeks.

Expressed tenosynovitis, degeneration of the biceps brachii long head tendon.

Pulley lesion (damage of ligaments, keeping the biceps brachii long head tendon) of II, III, IV type according to Habermeyer

Dislocations of biceps brachii long head tendon, types 1a, 1b and 2^nd type of injury according to Habermeyer and Walch

Surgical treatment.

In the majority of cases, surgical intervention is indicated for the patients with injured biceps brachii long head tendon. It could be tenotomy or tenodesis of the tendon under general anesthesia. Operation includes arthroscopic revision (through punctures 3-5 mm) and debridement (cleaning) of the shoulder joint. The tendon of the biceps brachii long head is extracted, extent of damage thereof is defined and surgical treatment is made depending on the obtained results. The surgical procedure tales 40-60 minutes. In-hospital treatment takes 2-3 days.

Rehabilitation.

After surgical treatment, the patient’s upper limb shall be immobilized for 5 weeks in soft Desault’s bandage. After this period an active rehabilitation starts with physiotherapy coach. Physical loading in gym or fitness-center are allowed in 4-6 weeks. 9 months later, full range of motions are permitted for the patients, as well as loading on the upper limb being operated.