Rupture Long Head Biceps: Difference between revisions

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== Search Strategy  ==
== Search Strategy  ==


'''Search databases:'''
'''Search databases:'''  


- pubmed<br>- google scholar<br>- Web of knowledge  
- pubmed<br>- google scholar<br>- Web of knowledge  


<br>'''Search words''':<br>- long head biceps rupture<br>- long head biceps tendon<br>- biceps AND tendon AND rupture<br>- biceps AND tendon AND long head<br>
<br>'''Search words''':
 
- long head biceps rupture<br>- long head biceps tendon<br>- biceps AND tendon AND rupture<br>- biceps AND tendon AND long head<br>- biceps rupture AND therapy<br>- long head biceps rupture AND treatment<br>
 
<br>


== Definition/Description  ==
== Definition/Description  ==

Revision as of 11:18, 22 May 2013

Welcome to Vrije Universiteit Brussel's Evidence-based Practice project. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Cynthia Meert

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Search Strategy[edit | edit source]

Search databases:

- pubmed
- google scholar
- Web of knowledge


Search words:

- long head biceps rupture
- long head biceps tendon
- biceps AND tendon AND rupture
- biceps AND tendon AND long head
- biceps rupture AND therapy
- long head biceps rupture AND treatment


Definition/Description[edit | edit source]

Rupture of the biceps tendon often occurs after a sudden contraction of the biceps with resistance to flexion and supination of the forearm. Also intrinsic degeneration of the tendon release and frictional wear of the tendon belly may have an impact. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

The long head of the biceps has several functions like dynamic stabilizer of the glenohumeral joint and a depressor of the humeral headCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

Clinically Relevant Anatomy[edit | edit source]

The M. biceps brachii exists out of 2 parts: The long head and the short head The long head starts at the tuberculum supraglenoidale scapulae and is attached to the back of the tuberositas radii.[1]


There are speculations that the short head is used as more powerful elbow flexor, while the long head is more used as a powerful supinator.[2]

Epidemiology /Etiology[edit | edit source]

Biceps rupture mainly occurs in men between 40 and 60 years who already have a history of shoulder pain. Often this happens after lifting heavy objects.
Also younger men can have this injury but usually after a traumatic fall, heavy weightlifting or consistently sport activities such as snowboarding, soccer, ... [3] [4]

Characteristics/Clinical Presentation[edit | edit source]

Some patients hear a pop at the time of the trauma, others feel a sudden pain in the anterior shoulder. [5] [6]
If there is a rupture of the distal biceps tendon, a Popeye deformity can be seen.[7]

Differential Diagnosis[edit | edit source]

add text here

Diagnostic Procedures[edit | edit source]

add text here related to medical diagnostic procedures

Outcome Measures[edit | edit source]

add links to outcome measures here (also see Outcome Measures Database)

Examination[edit | edit source]

MRI findings in two planes, axial and parasagittal, is required to diagnose accurate a rupture of the biceps tendon.[8]

Medical Management
[edit | edit source]

There is no consensus about surgical repair.

  • Generally they do surgery for young, athletic patients or patients who needs maximum supination strength.
    -> Patients lose up to 20% of supination strength but there is rarely impact on ADL.
  • Non-operative management is considered appropriate for older patients or patients who do not require a high level of supination strength.[9]

Physical Therapy Management
[edit | edit source]

• without surgery:
- we can do mobilizations
- control swelling by cold modalities such as cold packs, ice massage
- against inflammation: NSAIDs except for contraindications
- Preserving ROM:

       *Codman pendulum exercises

       *Functional exercises


• After surgery:
- 10 - 14d: soft sling + light exercises for ROM
- 14d - 6 to 8w: functional exercises using pulleys or therapy bands
- after 6 à 8w: moderate loading may be tolerated but heavy loading is prohibited for the first months. [10]

Key Research[edit | edit source]

add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)

Resources
[edit | edit source]

add appropriate resources here

Clinical Bottom Line[edit | edit source]

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Recent Related Research (from Pubmed)[edit | edit source]

see tutorial on Adding PubMed Feed

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References[edit | edit source]

  1. ↑ SHUNKE M., SCHULTE E., SCHUMACHER, ‘Anatomische atlas Prometheus: Algemene anatomie en bewegingsapparaat., Nederland, Bohn Stafleu Van Loghum, 2005
  2. ↑ QUACH TONY, JAZAYERI REZA, SHERMAN ORRIN H., et al;, ‘Distal biceps tendon injuries. Current treatment options.’, Bulletin of the NYU hospital for joint diseases, 2010, 68 (2):103-111
  3. ↑ QUACH TONY, JAZAYERI REZA, SHERMAN ORRIN H., et al;, ‘Distal biceps tendon injuries. Current treatment options.’, Bulletin of the NYU hospital for joint diseases, 2010, 68 (2):103-111
  4. ↑ GARY L BRANCH, ‘biceps rupture’, medscape reference, 2009
  5. ↑ QUACH TONY, JAZAYERI REZA, SHERMAN ORRIN H., et al;, ‘Distal biceps tendon injuries. Current treatment options.’, Bulletin of the NYU hospital for joint diseases, 2010, 68 (2):103-111
  6. ↑ GARY L BRANCH, ‘biceps rupture’, medscape reference, 2009
  7. ↑ QUACH TONY, JAZAYERI REZA, SHERMAN ORRIN H., et al;, ‘Distal biceps tendon injuries. Current treatment options.’, Bulletin of the NYU hospital for joint diseases, 2010, 68 (2):103-111
  8. ↑ ZANETTI MARCO, WEISHAUPT DOMINIK, GERBER CHRISTIAN, HODLER JUERG, ‘tendinopathy and rupture of the tendon of the long head of the biceps brachii muscle: evaluation with MR arthrography, AJR, 1998, 170:1557-1561
  9. ↑ GARY L BRANCH, ‘biceps rupture’, medscape reference, 2009
  10. ↑ GARY L BRANCH, ‘biceps rupture’, medscape reference, 2009

[1] 

  1. ↑ GURMINA STEFANO, CARBONE STEFANO, PERUGIA DARIO et al, ‘Rupture of the long head biceps tendon treated with tenodesis to the coracoids process. Results at more than 30 years.’, International orthopaedics, 2011, 35:713-716
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