Surena Namdari1, Mary Ann Keenan1. 1. Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, 34th and Spruce Streets, 2nd Floor, Silverstein Building, Philadelphia, PA 19104. E-mail address for M.A. Keenan: maryann.keenan@uphs.upenn.edu.
Abstract
INTRODUCTION: This article describes our biceps suspension procedure for painful inferior subluxation of the glenohumeral joint in hemiparetic patients. STEP 1 POSITION PATIENT AND EXPOSE THE BICEPS TENDON: Position the patient supine and expose the long head of the biceps tendon. STEP 2 CREATE TUNNEL: Use a curet to connect holes drilled at the superior and inferior aspects of the lesser tuberosity. STEP 3 PREPARE BICEPS TENDON: Incise the tendon at the musculotendinous junction to preserve as much length of the biceps tendon as possible. STEP 4 CREATE SUSPENSION: Create a loop with the tendon, and suture the distal end to the proximal end. STEP 5 POSTOPERATIVE PROTOCOL: Use a sling for three months, followed by active range-of-motion exercises. RESULTS: In summary, all patients noted pain relief after surgery, ten (of eleven) noted decreased deformity, and nine were "very satisfied" with the outcome. WHAT TO WATCH FOR: IndicationsContraindicationsPitfalls & Challenges.
INTRODUCTION: This article describes our biceps suspension procedure for painful inferior subluxation of the glenohumeral joint in hemiparetic patients. STEP 1 POSITION PATIENT AND EXPOSE THE BICEPS TENDON: Position the patient supine and expose the long head of the biceps tendon. STEP 2 CREATE TUNNEL: Use a curet to connect holes drilled at the superior and inferior aspects of the lesser tuberosity. STEP 3 PREPARE BICEPS TENDON: Incise the tendon at the musculotendinous junction to preserve as much length of the biceps tendon as possible. STEP 4 CREATE SUSPENSION: Create a loop with the tendon, and suture the distal end to the proximal end. STEP 5 POSTOPERATIVE PROTOCOL: Use a sling for three months, followed by active range-of-motion exercises. RESULTS: In summary, all patients noted pain relief after surgery, ten (of eleven) noted decreased deformity, and nine were "very satisfied" with the outcome. WHAT TO WATCH FOR: IndicationsContraindicationsPitfalls & Challenges.