切换至 "中华医学电子期刊资源库"

中华肩肘外科电子杂志 ›› 2023, Vol. 11 ›› Issue (01) : 83 -88. doi: 10.3877/cma.j.issn.2095-5790.2023.01.014

综述

肱二头肌长头腱损伤的诊断及研究进展
王学辉1, 蔚磊1,()   
  1. 1. 014010 内蒙古科技大学包头医学院第一附属医院关节运动医学一科
  • 收稿日期:2022-05-19 出版日期:2023-02-05
  • 通信作者: 蔚磊
  • 基金资助:
    内蒙古自治区卫生健康科技计划项目(202201415)

Diagnosis and research progress of long head biceps tendon injury

Xuehui Wang1, Lei Wei1()   

  • Received:2022-05-19 Published:2023-02-05
  • Corresponding author: Lei Wei
引用本文:

王学辉, 蔚磊. 肱二头肌长头腱损伤的诊断及研究进展[J/OL]. 中华肩肘外科电子杂志, 2023, 11(01): 83-88.

Xuehui Wang, Lei Wei. Diagnosis and research progress of long head biceps tendon injury[J/OL]. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2023, 11(01): 83-88.

肱二头肌长头腱(long head of the biceps tendon,LHBT)绝大部分起自盂上结节和上盂唇,少部分起自盂唇的其他位置,是人体唯一分为关节内段和关节外段肌腱。LHBT的主要功能是曲肘和使前臂旋后,但其在肩部的功能尚存在争议。单纯的LHBT损伤少见,约95%的LHBT损伤多与结节间沟解剖、肩袖损伤、肩峰撞击综合征、肩锁关节紊乱和肩关节前上撞击综合征等疾病有关,明确诊断仍有一定的难度。目前,LHBT损伤机制包括:LHBT肌腱炎或腱鞘炎、LHBT半脱位或脱位、LHBT部分撕裂或完全断裂、肩关节上盂唇损伤、滑车结构损伤。LHBT损伤分型大致分为直接损伤与间接损伤。由于LHBT损伤常伴随肩关节的其他疾病,明确诊断仍有一定的难度,需要结合病史、体格检查和影像学检查,甚至需要有经验的医师反复体格检查及查阅影像学资料后才可确诊。本文从肱二头肌长头腱损伤的解剖、生物力学功能、损伤机制与分型、组织病理研究和诊断进行综述报道,有望对肱二头肌长头腱损伤患者的诊断提供参考。

图1 LHBT解剖结构[1]注:LHBT为肱二头肌长头腱
[1]
Churgay CA. Diagnosis and treatment of biceps tendinitis and tendinosis[J]. Am Fam Physician200980(5):470-476.
[2]
Godenèche A, Nové-Josserand L, Audebert S, et al. Relationship between subscapularis tears and injuries to the biceps pulley[J]. Knee Surg Sports Traumatol Arthrosc201725(7):2114-2120.
[3]
Kang Y, Lee JW, Ahn JM, et al. Instability of the long head of the biceps tendon in patients with rotator cuff tear: evaluation on magnetic resonance arthrography of the shoulder with arthroscopic correlation[J]. Skeletal Radiol201746(10):1335-1342.
[4]
Gleason PD, Beall DP, Sanders TG, et al. The transverse humeral ligament: a separate anatomical structure or a continuation of the osseous attachment of the rotator cuff?[J]. Am J Sports Med200634(1):72-77.
[5]
Lafrance R, Madsen W, Yaseen Z, et al. Relevant anatomic landmarks and measurements for biceps tenodesis[J]. Am J Sports Med201341(6):1395-1399.
[6]
McGahan PJ, Patel H, Dickinson E, et al. The effect of biceps adhesions on glenohumeral range of motion: a cadaveric study[J]. J Shoulder Elbow Surg201322(5):658-665.
[7]
Cheng NM, Pan WR, Vally F, et al. The arterial supply of the long head of biceps tendon: Anatomical study with implications for tendon rupture[J]. Clin Anat201023(6):683-692.
[8]
Alpantaki K, Savvaki M, Karagogeos D. Expression of cell adhesion molecule L1 in the long head of biceps tendon[J]. Cell Mol Biol (Noisy-le-grand)201056 :1286-1289.
[9]
Tosounidis T, Hadjileontis C, Triantafyllou C, et al. Evidence of sympathetic innervation and α1-adrenergic receptors of the long head of the biceps brachii tendon[J]. J Orthop Sci201318(2):238-244.
[10]
Bottegoni C, Farinelli L, Aquili A, et al. Fibrocartilaginous metaplasia identified in the long head of the biceps brachii[J]. J Shoulder Elbow Surg201827(7):1221-1225.
[11]
Kany J, Guinand R, Amaravathi RS, et al. The keyhole technique for arthroscopic tenodesis of the long head of the biceps tendon. In vivo prospective study with a radio-opaque marker[J]. Orthop Traumatol Surg Res2015101(1):31-34.
[12]
张磊,张晟,李智尧,等.肩关节上盂唇前后部及肱二头肌长头肌腱损伤手术方式的选择及临床疗效[J/CD] .中华肩肘外科电子杂志, 2016,4(3):150-155.
[13]
Gill TJ, McIrvin E, Mair SD, et al. Results of biceps tenotomy for treatment of pathology of the long head of the biceps brachii[J]. J Shoulder Elbow Surg200110(3):247-249.
[14]
Giphart JE, Elser F, Dewing CB, et al. The long head of the biceps tendon has minimal effect on in vivo glenohumeral kinematics: a biplane fluoroscopy study[J]. Am J Sports Med201240(1):202-212.
[15]
Hawkes DH, Alizadehkhaiyat O, Kemp GJ, et al. Electromyographic assessment of muscle fatigue in massive rotator cuff tear[J]. J Electromyogr Kinesiol201525(1):93-99.
[16]
Vestermark GL, Van Doren BA, Connor PM, et al. The prevalence of rotator cuff pathology in the setting of acute proximal biceps tendon rupture[J]. J Shoulder Elbow Surg201827(7):1258-1262.
[17]
Gill HS, El Rassi G, Bahk MS, et al. Physical examination for partial tears of the biceps tendon[J]. Am J Sports Med200735(8):1334-1340.
[18]
Gerber C, Sebesta A. Impingement of the deep surface of the subscapularis tendon and the reflection pulley on the anterosuperior glenoid rim: a preliminary report[J]. J Shoulder Elbow Surg20009(6):483-490.
[19]
Boesmueller S, Fialka C, Pretterklieber ML. The arterial supply of the tendon of the long head of the biceps brachii in the human: a combined anatomical and radiological study[J]. Ann Anat2014196(6):449-455.
[20]
Khazzam M, George MS, Churchill RS, et al. Disorders of the long head of biceps tendon [J]. J Shoulder Elbow Surg201221(1):136-145.
[21]
Murthi AM, Vosburgh CL, Neviaser TJ. The incidence of pathologic changes of the long head of the biceps tendon[J]. J Shoulder Elbow Surg20009(5):382-385.
[22]
赵加松,汪国友,曾胜强,等.肱二头肌长头腱切断结节间沟下关节外固定治疗老年SLAP损伤患者的疗效分析[J/CD] .中华肩肘外科电子杂志, 2017,5(3):180-185.
[23]
陈礼阳,易诚青. 肱二头肌长头腱滑车结构损伤的特点及研究进展[J/CD]. 中华肩肘外科电子杂志, 2021, 9(3):281-283.
[24]
Bennett WF. Arthroscopic repair of anterosuperior (supraspinatus/subscapularis) rotator cuff tears: a prospective cohort with 2- to 4-year follow-up. Classification of biceps subluxation/instability[J]. Arthroscopy200319(1):21-33.
[25]
万彦林,李轶津,姜文学.肱二头肌长头腱沙漏样改变一例及文献复习[J/CD] .中华肩肘外科电子杂志,2020,8(3):268-271.
[26]
Habermeyer P, Magosch P, Pritsch M, et al. Anterosuperior impingement of the shoulder as a result of pulley lesions: a prospective arthroscopic study[J]. J Shoulder Elbow Surg200413(1):5-12.
[27]
Snyder SJ, Karzel RP, Pizzo WD, et al. Arthroscopy classics. SLAP lesions of the shoulder[J]. Arthroscopy201026(8):1117.
[28]
Lafosse L, Reiland Y, Baier GP, et al. Anterior and posterior instability of the long head of the biceps tendon in rotator cuff tears: a new classification based on arthroscopic observations[J]. Arthroscopy200723(1):73-80.
[29]
Martetschläger F, Zampeli F, Tauber M, et al. Lesions of the biceps pulley: a prospective study and classification update[J]. JSES Int20204(2):318-323.
[30]
Bottegoni C, Farinelli L, Aquili A, et al. Fibrocartilaginous metaplasia identified in the long head of the biceps brachii[J]. J Shoulder Elbow Surg201827(7):1221-1225.
[31]
Glait SA, Mahure S, Loomis CA, et al. Regional histologic differences in the long head of the biceps tendon following subpectoral biceps tenodesis in patients with rotator cuff tears and SLAP lesions[J]. Knee Surg Sports Traumatol Arthrosc201826(8):2481-2489.
[32]
Joseph M, Maresh CM, McCarthy MB, et al. Histological and molecular analysis of the biceps tendon long head post-tenotomy[J]. J Orthop Res200927(10):1379-1385.
[33]
Dierickx C, Ceccarelli E, Conti M, et al. Variations of the intra-articular portion of the long head of the biceps tendon: a classification of embryologically explained variations[J]. J Shoulder Elbow Surg200918(4):556-565.
[34]
Simon MJK, Yeoh J, Nevin J, et al. Histopathology of long head of biceps tendon removed during tenodesis demonstrates degenerative histopathology and not inflammatory changes[J]. BMC Musculoskelet Disord202223(1):185.
[35]
李震,陈贞月,李景银,等.肱二头肌长头肌腱的研究进展[J].中国矫形外科杂志,2019,27(16):1491-1496.
[36]
Holtby R, Razmjou H. Accuracy of the Speed's and Yergason's tests in detecting biceps pathology and SLAP lesions: comparison with arthroscopic findings[J]. Arthroscopy200420(3):231-236.
[37]
Rosas S, Krill MK, Amoo-Achampong K, et al. A practical, evidence-based, comprehensive (PEC) physical examination for diagnosing pathology of the long head of the biceps[J]. J Shoulder Elbow Surg, 2017, 26(8): 1484-1492.
[38]
Cardoso A, Amaro P, Barbosa L, et al. Diagnostic accuracy of clinical tests directed to the long head of biceps tendon in a surgical population: a combination of old and new tests [J]. J Shoulder Elbow Surg, 2019, 28(12): 2272-2278.
[39]
Nho SJ, Strauss EJ, Lenart BA, et al. Long head of the biceps tendinopathy: diagnosis and management[J]. J Am Acad Orthop Surg201018(11):645-656.
[40]
O'Brien SJ, Pagnani MJ, Fealy S, et al. The active compression test: a new and effective test for diagnosing labral tears and acromioclavicular joint abnormality[J]. Am J Sports Med199826(5):610-613.
[41]
Morgan CD, Burkhart SS, Palmeri M, et al. Type II SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears[J]. Arthroscopy199814(6):553-565.
[42]
Sethi N, Wright R, Yamaguchi K. Disorders of the long head of the biceps tendon[J]. J Shoulder Elbow Surg19998(6):644-654.
[43]
Li D, Wang W, Liu Y, et al. The backward traction test: a new and effective test for diagnosis of biceps and pulley lesions[J]. J Shoulder Elbow Surg202029(2):e37-e44.
[44]
Zabrzyński J, Paczesny Ł, Zabrzyńska A, et al. Sonography in the instability of the long head of the biceps tendon confronted with histopathologic and arthroscopic findings[J]. Folia Morphol (Warsz)201877(3):583-590.
[45]
Armstrong A, Teefey SA, Wu T, et al. The efficacy of ultrasound in the diagnosis of long head of the biceps tendon pathology[J]. J Shoulder Elbow Surg200615(1):7-11.
[46]
Hsu SH, Miller SL, Curtis AS. Long head of biceps tendon pathology: management alternatives[J]. Clin Sports Med200827(4):747-762.
[47]
Rol M, Favard L, Berhouet J. Diagnosis of long head of biceps tendinopathy in rotator cuff tear patients: correlation of imaging and arthroscopy data[J]. Int Orthop201842(6):1347-1355.
[48]
Mohtadi NG, Vellet AD, Clark ML, et al. A prospective, double-blind comparison of magnetic resonance imaging and arthroscopy in the evaluation of patients presenting with shoulder pain[J]. J Shoulder Elbow Surg200413(3):258-265.
[49]
De Maeseneer M, Boulet C, Pouliart N, et al. Assessment of the long head of the biceps tendon of the shoulder with 3T magnetic resonance arthrography and CT arthrography[J]. Eur J Radiol201281(5):934-939.
[50]
Fischer C, Krammer D, Hug A, et al. Dynamic contrast-enhanced ultrasound and elastography assess deltoid muscle integrity after reverse shoulder arthroplasty[J]. J Shoulder Elbow Surg201726(1):108-117.
[51]
Fischer C, Gross S, Zeifang F, et al. Contrast-Enhanced Ultrasound Determines Supraspinatus Muscle Atrophy After Cuff Repair and Correlates to Functional Shoulder Outcome[J]. Am J Sports Med201846(11):2735-2742.
[52]
Hart ND, Golish SR, Dragoo JL. Effects of arm position on maximizing intra-articular visualization of the biceps tendon: a cadaveric study[J]. Arthroscopy201228(4):481-485.
[53]
Taylor SA, Khair MM, Gulotta LV, et al. Diagnostic glenohumeral arthroscopy fails to fully evaluate the biceps-labral complex[J]. Arthroscopy201531(2):215-224.
[1] 王亚红, 蔡胜, 葛志通, 杨筱, 李建初. 颅骨骨膜窦的超声表现一例[J/OL]. 中华医学超声杂志(电子版), 2024, 21(11): 1089-1091.
[2] 李友, 唐林峰, 杜伟伟, 刘海亮, 余新水, 沈佳宇, 巨积辉. 皮瓣联合掌长肌腱折叠单排三点式固定治疗指背侧创面伴锤状指畸形的临床效果观察[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 485-490.
[3] 雷子威, 凌萍, 沈纵, 魏晨如, 朱邦晖, 伍国胜, 孙瑜. 类器官肺损伤疾病模型构建及应用的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 531-535.
[4] 张洁, 罗小霞, 余鸿. 系统性免疫炎症指数对急性胰腺炎患者并发器官功能损伤的预测价值[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 68-71.
[5] 韩萌萌, 冯雪园, 马宁. 乳腺癌改良根治术后桡神经损伤1例[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 117-118.
[6] 王学虎, 赵渝. 复杂腹壁疝手术中血管损伤并发症的预防和处理[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 616-619.
[7] 中华医学会器官移植学分会. 肝移植术后缺血性胆道病变诊断与治疗中国实践指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 739-748.
[8] 郑大雯, 王健东. 胆囊癌辅助诊断研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 769-773.
[9] 沈炎, 张俊峰, 唐春芳. 预后营养指数结合血清降钙素原、胱抑素C及视黄醇结合蛋白对急性胰腺炎并发急性肾损伤的预测价值[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 536-540.
[10] 李浩, 陈棋帅, 费发珠, 张宁伟, 李元东, 王硕晨, 任宾. 慢性肝病肝纤维化无创诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 863-867.
[11] 谭瑞义. 小细胞骨肉瘤诊断及治疗研究现状与进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 781-784.
[12] 王子阳, 王宏宾, 刘晓旌. 血清标志物对甲胎蛋白阴性肝细胞癌诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 677-681.
[13] 陈慧, 邹祖鹏, 周田田, 张艺丹, 张海萍. 皮肤镜对头皮红斑性皮肤病辅助鉴别诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 692-698.
[14] 颜世锐, 熊辉. 感染性心内膜炎合并急性肾损伤患者的危险因素探索及死亡风险预测[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 618-624.
[15] 胡云鹤, 周玉焯, 付瑞瑛, 于凡, 李爱东. CHS-DRG付费制度下GB1分组住院费用影响因素分析与管理策略探讨[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 568-574.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?