Lesões agudas do tendão distal do bíceps: Diagnóstico e tratamento

Luiz Henrique Boraschi Vieira Ribas; Breno Schor; Geraldo da Rocha Motta Filho; Paulo Santoro Belangero

doi:10.1055/s-0043-1771488

Revista Brasileira de Ortopedia, Table of Contents

CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(05): e689-e697
DOI: 10.1055/s-0043-1771488

Artigo de Atualização

Ombro e Cotovelo

Lesões agudas do tendão distal do bíceps: Diagnóstico e tratamento

Article in several languages: português | English

Luiz Henrique Boraschi Vieira Ribas

¹Aluno do Programa de Pós-Graduação do Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil

²Médico ortopedista, especialista em Ombro e Cotovelo, Instituto Vita, São Paulo, SP, Brasil

,

Breno Schor

²Médico ortopedista, especialista em Ombro e Cotovelo, Instituto Vita, São Paulo, SP, Brasil

,

Geraldo da Rocha Motta Filho

³Médico ortopedista, especialista em Ombro e Cotovelo, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil

,

Paulo Santoro Belangero

⁴Cirurgião ortopçdico, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil

› Author Affiliations

Abstract

Resumo

As lesões agudas do tendão distal do bíceps se apresentam, clinicamente, com uma dor súbita associada a perda aguda de força de flexão e supinação. Seu principal mecanismo de lesão ocorre durante contração excêntrica do bíceps. O “Hook Test” é o principal teste semiológico, sendo o mais sensível e específico. A ressonância magnética, exame padrão ouro para o diagnóstico, pode fornecer informações sobre a integridade, identificando as lesões parciais e/ou completas. O tratamento cirúrgico pode ser realizado por duas vias principais: anterior e por dupla via porém as técnicas de reinserção tendínea são diversas não havendo evidência clínica que recomende um método de fixação em detrimento ao outro; embora o botão cortical apresente maior resistência a falha nos estudos biomecânicos. Com o tratamento cirúrgico o retorno as atividades laborais foi de 89% em 14 semanas (média) porém ao esporte de alto rendimento o prazo foi longo, média de 1 ano, e não duradouro.

Palavras-chave

articulação do cotovelo/lesões - músculo esquelético - ruptura - lesões dos tendões

Full Text

References

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