Functional results following suture repair after rupture of the long biceps tendon considering shoulder impingement

Operative treatment for ruptures of the long biceps tendon still is discuss ed controversially. In the present literature the keyhole-technique is reco mmended according to favourable biomechanical conditions. In recent years r efixation to the short biceps tendon was preferred. Now it is supposed that this technique may provocate subacromial impingement considering the loss of depression function of the long biceps tendon to the humeral head. Between 1980 to 1991 83 patients with rupture of the long biceps tendon wer e treated operatively by refixation to the short head. 28 patients were inv estigated after an average follow-up of 6,5 years. Due to the criterias of the Constant-Score 85% of patients achieved very good, 15% good results. At our patients provocation of a subacromial impingement could not be observe d. The subacromial space was not reduced in the postoperative x-ray control . Compared with the non-operated shoulder isokinetic determination of isome tric maximal peak torque for elbow-flexion, shoulder-abduction and shoulder -flexion yield to almost identical results for the operated shoulder. Refixation to the short head can be advised for treatment of ruptures of th e long biceps tendon due to the certain technique with a low complication r ate and very good functional outcome.