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Z Orthop Unfall 2010; 148(4): 477-488
DOI: 10.1055/s-0030-1250238
Refresher Orthopädie und Unfallchirurgie
Rubrikherausgeber: R. Hoffmann, Frankfurt, R. Windhager, Graz
© Georg Thieme Verlag KG Stuttgart · New York

Operative Therapie distaler Bizepssehnenrupturen

S. Siebenlist1 [*] , K. Schmidt-Horlohé2 [*] , R. Hoffmann2 , U. Stöckle1 , F. Elser1
  • 1Klinikum rechts der Isar, Abteilung für Unfallchirurgie, TU München
  • 2Zentrum für Unfallchirurgie und Orthopädische Chirurgie, BG Unfallklinik Frankfurt am Main
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Publication History

Publication Date:
16 August 2010 (online)

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Zusammenfassung

Die Ruptur der distalen Bizepssehne hat eine niedrige Inzidenz und betrifft nahezu ausschließlich Männer zwischen dem 30.–60. Lebensjahr. Die operative Therapie dient dem Ziel der Wiederherstellung der Flexions- und Supinationskraft. Dieser CME-Refresher soll neben den anatomischen, pathophysiologischen und epidemiologischen Grundlagen der Vermittlung der diversen Behandlungstechniken dienen. Sowohl die operativen Zugänge in offener und minimalinvasiver, „Single“- oder „Double-Incision“-Technik als auch die Refixationsmethoden, angefangen mit der klassischen transossären Refixation über neuere Techniken wie Endobutton, Fadenanker oder Interferenzschraubenfixierung werden ausführlich erörtert. Abschließend wird den Nachbehandlungskonzepten und gutachterlichen Aspekten Aufmerksamkeit geschenkt.

Summary

Ruptures of the distal biceps tendon are rare injuries which nearly exclusively occur in middle-aged men when eccentric load is applied to the flexed elbow. Operative treatment is supposed to be the most effective method to restore flexion and supination strength. However, there is a wide variety of potential surgical treatment methods. This article is aiming to present the anatomical, pathophysiological and epidemiological basics and to demonstrate the surgical techniques. Not only the approaches but also the differing fixation methods like bone tunnel fixation, endobutton- or suture anchor and interference screw are described in detail. Additionally, rehabilitation protocols and considerations concerning medical expertise are presented.

Bei fehlenden Kontraindikationen gegen eine OP sollten distale Bizepssehnenrupturen operativ behandelt werden.

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1 S. Siebenlist und K. Schmidt-Horlohé trugen zu gleichen Teilen zum vorliegenden Artikel bei.

Dr. med. Sebastian Siebenlist

Abteilung für Unfallchirurgie
Technische Universität München

Ismaningerstraße 22

81675 München

Email: siebenlist@uchir.me.tum.de

Dr. med. Kay Schmidt-Horlohé

Zentrum für Unfallchirurgie und Orthopädische Chirurgie
Berufsgenossenschaftliche Unfallklinik Frankfurt am Main

Friedberger Landstraße 430

60389 Frankfurt am Main

Email: kay.schmidt-horlohe@bgu-frankfurt.de