[Long-term results of surgical and conservative treatment of ruptures of the long biceps tendon].

INTRODUCTION

The therapeutic concept for rupture of the long biceps tendon continues to be controversially discussed. Various operative procedures compete with mostly unstructured conservative ones. QUESTION INVESTIGATED: a) Is operative therapy of the long biceps tendon rupture superior to the conservative treatment? b) For which group of patients should the operative or the conservative therapy be recommended?

PATIENTS AND METHOD: The value of operative versus conservative therapy was examined based on a collective of 43 ruptures (39 patients), 31 operatively and twelve conservatively treated. The investigation comprised the following: 1) the subjective evaluation of the long-term result by the patient, 2) a thorough clinical examination including the function of the shoulder and the elbow joint and 3) an isokinetic force and endurance test on Cybex II. The results of the follow-up were evaluated by a score.

RESULTS

It was found that very good but also poor results can be achieved with both operative and conservative therapy, the good results distinctly predominating in the operated collective. Statistically significant differences could not be detected because of the small number of cases and the relatively large variation range. Good results after conservative therapy require a differentiated rehabilitation program corresponding to the normal course followed after operative treatment.

CONCLUSION

Since results tended to be better for the operated collective in our study, we recommend a surgical procedure for active younger patients. It seems to be of decisive importance to perform the operation as early as possible and to achieve optimal tension of the muscle by refixation of the tendon.