LATE RESULTS AFTER OPERATIVE AND CONSERVA TIVE TREATMENT OF LONG BICEPS TENDON RUPTURES

Introduction: The therapeutic concept for rupture of the long biceps t endon continues to be controversially discussed. Various operative pro cedures compete with mostly unstructured conservative ones. Question i nvestigated: a) Is operative therapy of the long biceps tendon rupture superior to the conservative treatment? b) For which group of patient s should the operative or the conservative therapy be recommended? Pat ients and method: The value of operative versus conservative therapy w as examined based on a collective of 43 ruptures (39 patients), 31 ope ratively and twelve conservatively treated. The investigation comprise d the following: 1) the subjective evaluation of the long-term result by the patient, 2) a thorough clinical examination including the funct ion of the shoulder and the elbow joint and 31 an isokinetic forte and endurance test on Cybex II. The results of the follow-up were evaluat ed by a score. Results: It was found that ver: good but also poor resu lts can be achieved with hath operative and conservative therapy, the good results distinctly; predominating in the operated collective. Sta tistically significant differences could not be detected because of th e small number of cases and the relatively large variation range. Good results after conservative therapy require a differentiated rehabilit ation program corresponding to the normal course followed after operat ive treatment. Conclusion: Since results tended to be better for the o perated collective in our study, we recommend a surgical procedure for active younger patients. It seems to be of decisive importance to per form the operation as early as possible and to achieve optimal tension of the muscle by refixation of the tendon.