Rupture of the rotator cuff of the shoulder associated with rupture of the tendon of the long head of the biceps.

Twenty cases of associated rupture of the rotator cuff and the tendon of the long head of the biceps were studied. This was out of a series of 54 patients referred to our unit with symptoms referable to the rotator cuff or to recent tendon rupture. In the majority of these patients there was marked loss of shoulder function due to rupture of the cuff. In 13 of 15 patients treated surgically the cuff lesion was either substantial or severe. The tendon lesion was partial in 3 cases and total in 12. In addition to repairing the cuff, the tendon was fixed in the bicipital groove in 7 of the 15 patients operated on. In 2 of 3 patients with partial rupture the tendon was not fixed but after several months the partial rupture became complete. The results in the 15 cases of associated ruptures treated surgically were satisfactory in 11 cases (73%) as determined by recovery of shoulder function. Fixation of the tendon was carried out in all the partial ruptures (13 cases), and in complete ruptures if they were recent or not more than 6 months duration in subjects of middle age or slightly more. Of the 12 complete ruptures fixation generally improved the power of elbow flexion and supination and reduced or diminished the cosmetic defect due to the bulge on the front of the arm which the biceps was contracted.