Management of Biceps Brachii Tendon Disorders
M.A.Mashhour, E.M.Ibrahim, E.M.Bayomy and A.M.Abd El Hamid"
The Long Head of Biceps originates at the supraglenoid tubercle and the superior glenoid labrum. It inserts distally, along with the short head of the biceps, onto the radial tuberosity, with an attachment to the fascia of the medial forearm via the bicipital aponeurosis.The site of the LHB origin from the glenoid labrum is variable; in most cases, it arises either mostly posterior or completely posterior [55.4% and 27.7%, respectively]. Type I lesions are treated with conservative debridement of the frayed labrum. Type II lesions are repaired using a single-anchor, double-suture technique. Type III lesions are treated by initial resection of the unstable bucket-handle labral fragment, followed by inspection of the biceps anchor attachment for stability. Type IV lesions are treated as type III lesions unless the biceps tendon split is severe. When more than approximately 30% of the tendon is included with the displaced labral tear one must consider either repairing the tendon , or releasing it and repairing the labrum as with a type II SLAP , or performing a biceps tenodesis . the decision depends on the age and activity level of the patient and the condition of the remainder of the biceps tendon.
Biceps, LHB origin.