暂无摘要。

OBJECTIVE: To assess the feasibility, operative time, clinical outcomes, possible complications, and failure rates of all-through arthroscopic biceps tenodesis using press-fit bony plug technique.
METHODS: This prospective case series study involved 30 skeletally mature patients with long head of biceps pathology (tendinitis after failure of conservative treatment, subluxation, dislocation, or tendon tears). All patients were followed up for 24 months at least.
RESULTS: Twenty-nine patients regained full shoulder and elbow range of motion; one case suffered from reflex sympathetic dystrophy. There was a significant improvement in the constant, ASES, and VAS scores when comparing the pre-operative and post-operative values. The average biceps strength was 96% compared to the opposite healthy side. No cases were complicated by neuro-vascular deficits or failure of the tenodesis.
CONCLUSIONS: Press-fit biceps tenodesis is safe and accessible with low economic demands. We recommend this technique to be used more often when addressing patients with long head of biceps pathologies.
UNASSIGNED: Registration number: N-1562023. Registration date: June 2022 \"Retrospectively registered\".

BACKGROUND: Dislocation of the long head of biceps tendon (LHBT) usually involves rotator cuff injury, and isolated dislocation with an intact rotator cuff is rare. Some cases of isolated dislocation have been reported. However, to the best of our knowledge, there has been no report of bilateral dislocation of the LHBT without rotator cuff pathology.
METHODS: A 23-year-old male presented to our outpatient clinic with left side dominant pain in both shoulders. The patient had no history of trauma or overuse. The patient underwent intra-articular injection and physical therapy, but his symptoms aggravated. Based on preoperative imaging, the diagnosis was bilateral dislocation of the LHBT. Dysplasia of the bicipital groove was detected in both shoulders. Active dislocation of the biceps tendon over an intact subscapularis tendon was identified by diagnostic arthroscopy. Staged biceps tenodesis was performed and continuous passive motion therapy was administered immediately after surgery. The patient\'s pain was resolved, and full functional recovery was achieved, and he was satisfied with the condition of his shoulders.
CONCLUSIONS: This study describes a rare case of bilateral dislocations of the LHBT without rotator cuff injury due to dysplasia of the bicipital groove.

暂无摘要。

This is a case of a 57-year-old healthy woman with traumatic bilateral distal biceps tendon rupture with tendon retraction requiring reconstruction. The functional outcomes were recorded pre-operatively and at 3 months, 6 months, 1 year and 2 years postoperatively. Conclusion: Distal biceps tendon rupture usually occurs in male patients; however, this injury may occur in females. Delay in treatment may result in tendon degeneration precluding repair. Distal biceps tendon reconstruction with Achilles allograft yielded favorable outcome in a middle-aged female patient who sustained bilateral distal biceps tendon rupture.

While neuromuscular fatigability has been previously characterized after running and cycling, no study has investigated an ultra-endurance upper body task. In preparation for a world record attempt, three pacing strategies to perform 1980 pull-ups in 6 hrs were compared during independent sessions: fast pace, long recovery (FL), fast pace, multiple short recoveries (FMS), and slow pace, no recovery (SN). Elbow flexion maximal voluntary contraction (MVC) force, grip strength, peripheral fatigue, and biceps brachii electromyography were quantified every 330 pull-ups and during recovery, alongside heart rate, perceived effort, and arm muscle pain. In all conditions, MVC force decreased rapidly within the first set of 330 pull-ups, with the greatest depression observed in FL (-29.1%) and more gradual declines in FMS (-18.6%) and SN (-8.6%). Similarly, FL displayed the greatest decline in potentiated single twitch (FL: -75.0%; FMS: -53.9%; SN: -41.8%) and high-frequency doublet forces (FL: -63.3%; FMS: -29.2%; SN: -41.8%) following the first set, as well as higher heart rate, effort, and pain throughout the task. Following 24 hrs, MVC force recovered slowest in FL and grip strength recovered fastest in SN. Therefore, for the world record attempt, a strategy with a continuous workload at slower pace should be used.

BACKGROUND: Recommended treatment for severely displaced proximal humeral fractures in children is the closed reduction and percutaneous fixation by K-wires or intramedullary nailing.
METHODS: From January 2016 to January 2017 6, 21 children/adolescents (range 8 to 16 years) with proximal humeral fractures were treated surgically for severe displacement. In these six patients, several attempts of closed reduction were unsuccessful, and an open reduction was performed. The humeral head was fixed with a 3.5 mm T-plate without affecting the growth plate. Plate removal was performed at a mean interval of 132 days after initial surgery. Two years after initial surgery, the clinical outcome was assessed by the Constant-Murley score and QuickDASH score (including sport/music and work) and the shoulder joint was evaluated with a standardized sonographic examination for the rotator cuff and the conjoint tendon.
RESULTS: In all six patients, dorsal displacement of the fracture was irreducible due to the interposition of tendinous or osseous structures. Intraoperatively, the interposed structures were the long biceps tendon in two, periosteal tissue in two, a bony fragment in one, and the long biceps tendon together with the conjoint tendon in one case. At mean follow-up of 26 months (range 22 months to 29 months), patients showed very good clinical results with an excellent mean Constant-Murley score of 97.5 (range 91 to 100) and mean QuickDASH score (including sport/music and work) of 5.5 (range 0-20.8). An X-ray follow-up 6 weeks after surgery demonstrated early consolidation and correct alignment in all patients. A sonographic evaluation at 2 years post injury showed that the biceps and the conjoined tendon were intact in all patients.
CONCLUSIONS: If a proximal humeral fracture is not reducible by closed means, a tissue entrapment (most likely biceps tendon) should be considered. Treatment with an open reduction and plate fixation yields very good clinical and radiological results and preserves interposed structures as the biceps and conjoint tendon.

The long head of the biceps tendon is stabilized in the intertubercular groove by several anatomical structures. Dislocation or identification of the biceps tendon into or within the subscapularis tendon is very rarely mentioned in the literature. This is the first reported case of bilateral identification of the long head of the biceps tendons within the lateral subscapularis tendon. This report presents the case of a 51-year-old male patient who presented for bilateral shoulder pain. After failure of conservative treatment, MRIs were done which identified bilateral biceps tendons within the subscapularis tendons, with a concomitant supraspinatus tear on the right side. He underwent right shoulder arthroscopic biceps tenotomy, with supraspinatus repair. The symptoms of the left shoulder diminished as a result of the continuation of conservative treatment. The long head of the biceps tendon normally travels through the intertubercular groove and is stabilized by soft tissue and bony structures. Medial dislocation of the tendon is affected by the medial wall angle and by the integrity of the soft tissue stabilizers; most importantly the coracohumeral ligament in the proximal part of the groove. Dislocation of the biceps tendon into the substance of the subscapularis has been rarely mentioned in the literature; and as far as we know, bilateral occurrence without any identifiable subscapularis tears has never been previously mentioned. The bilateral occurrence with the absence of subscapularis lesions indicates that this is a congenital anomaly.

Rare cases of a congenital absence of the long head of the biceps tendon (LHBT) have been reported, and its incidence is unknown. In a literature review of the congenital absence of the LHBT, only 1 case was associated with posterior shoulder instability and severe posterior glenoid dysplasia. This paper reports the first case of a patient with a bilateral congenital absence of the LHBT with posterior shoulder instability without glenoid dysplasia or posterior glenoid tilt. The patient experienced a traffic accident while holding the gear stick with his right hand. After the accident, a posteroinferior labral tear with paralabral cysts was detected on the magnetic resonance images. The congenital absence of the LHBT was assumed to have affected the posterior instability that possibly increased the susceptibility to a subsequent traumatic posterior inferior labral tear. This case was identified as a posterior inferior tear caused by a traumatic \'gear stick injury\'.

BACKGROUND: Intramuscular abscesses, particularly in the biceps brachii, are an extremely rare phenomenon. When present they are usually secondary to trauma, intramuscular injections, or systemic disease.
METHODS: A 56 year old diabetic woman presented to our emergency department with a 3 day history of fever, cough, and a painful left shoulder. Although she had a mechanical fall 2 weeks prior, she denied any pain in her shoulder immediately after the fall. She also denied any history of drug abuse or recent intramuscular injection. On examination she looked acutely unwell and was in acute septic shock requiring inotropic support. Computed tomography of her shoulder showed a large intramuscular abscess in her left biceps brachii muscle. She was immediately taken to the operating theatre for open exploration and washout of the abscess. The multiloculated abscess was tracking into the glenohumeral joint. Post operatively she showed significant clinical improvement and after a 2 week course of intravenous antibiotics recovered well and was discharged from hospital.
CONCLUSIONS: Intramuscular abscesses are usually seen in patients who are immunocompromised. Intramuscular needle injections and haematomas secondary to trauma are also risk factors. To the best of our knowledge, there have only been 4 published reports in the English literature of intramuscular abscess formation in the biceps brachii.
CONCLUSIONS: We report a case of a seemingly spontaneous intramuscular biceps abscess in a diabetic patient presenting with septic shock.