The biceps muscle is inserted in 2 places. The coracobiceps inserts at the level of the tip of the coracoid, and the long portion of the biceps (PLB) that runs along the bicipital groove,inserts intraarticularly into the supraglenoid area, forming the superior labrum. This last insertion is what usually covers most of his pathology.
2. SLAP INJURIES:
They usually occur in young people after repetitive trauma or in sports that use the arm in repetitive beating / throwing gestures, such as tennis or paddle in our midst. It implies a dislocation of the anterior superior labrum, in the area where the PLB arrives, as shown in blue in illustration 1. This disinsertion of the superior labrum is called a SLAP lesion (Superior Anterior to Posterior Labrum).
Illustration 1 Slap injury.
The diagnosis is established after a detailed clinical history along with an MRI to assess other structures and other shoulder factors. In certain cases, a resonance with a punctured contrast in the shoulder is necessary to evaluate these structures well.
The treatment of this pathology requires the arthroscopic reinsertion of the superior labrum in the youngest patients, with similar anchors used in the Bankart rupture repair.
3. PATHOLOGY OF THE LONG PORTION OF THE BICEPS (PLB):
In cases of more severe SLAP injury, or older patients with degeneration and marked synovitis of the PLB, the current trend is to perform a more distal biceps reattachment, to eliminate the pain that their disinsertion or degeneration cause. This can be done with an anchoring technique and sutures, as can be seen in Figure 2, although there are different alternatives to be evaluated by the Physician.
Illustration 2 Tenodesis of the long biceps portion.
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