OrthoFracs Logo

Rupture of Long Head Biceps

Epidemiology

  • 50% of biceps ruptures
  • Two groups
    • Young people with sudden unexpected lifting
    • Older patients (middle age or elderly) with associated impingement & little or no trauma
  • Isolated ruptures of biceps tendon only seen in 25% of cases
    • Rest had involvement of supraspinatus

Function of Biceps

  • Flexion of supinated forearm
  • Supination of the flexed forearm
  • Flexion of shoulder
  • Prevention of anterior displacement of G-H joint
  • Deceleration of the rapidly extending elbow (as in throwing)

Clinical

  • Sudden pain with lifting
  • Characteristic bulging arm contour "Popeye Muscle"
  • Soon after pain settles
  • Power
    • 20% loss of flexion power
    • Normal elbow flexion power
    • 10% loss of supination power

Treatment

  • Non operative
    • Indicated in most patients
  • Operative
      • In form of Tenodesis
    • Indications
      • Young patient with recent rupture that won’t accept deformity or mild loss of power
        • Particularly supination power
      • Older patient as part of treatment for impingement
    • Technique