Variantes anatómicas del tendón de la porción larga del biceps en su segmento intra-articular. Presentación de 2 casos y revisión bibliográfica / Developmental anormalities of the tendon of the long head of the biceps

Las anomalías del desarrollo del tendón de la porción larga del bíceps son poco frecuentes. La detención de la migración evolutiva del tendón hacia intra-articular durante las primeras semanas de la vida embrionaria y fetal darán lugar a las múltiples variantes anatómicas del segmento intra-articular del tendón. Presentamos 2 casos de variantes anatómicas del tendón de la porción larga del bíceps en su segmento intra-articular diagnosticadas sólo luego de la exploración artroscópica gleno-humeral. El tratamiento de estas anomalías congénitas depende en gran media del examen físico preoperatorio y del grado de movilidad que presente el tendón durante la exploración artroscópica.

Developmental anomalies of the tendon of the long head of the biceps are rare. The arrest of evolutionary migration of the tendon towards intra-articular during the first weeks of embryonic and fetal life will result in multiple anatomic variants of the intra-articular tendon segment. We report 2 cases of anatomical variants of the tendon of the long head of the biceps in its intra-articular segment diagnosed only after gleno-humeral arthroscopic examination. Treatment of these congenital anomalies depend to a large extent on preoperative physical examination as well as on mobility achieved by the tendon during arthroscopic examination.

Lesoes SLAP- Aspectos clinicos e patologicos / SLAP lesion- Pathologic and clinical aspects

Este trabalho de revisao bibliografica investiga as lesoes SLAP, que acometem o labio glenoidal superior, seus aspectos clinicos e patologicos. Estas sao frequentemente associadas a outras patologias e produzem sintomas muito vagos, levando a confusao diagnostica. Com base em achados artroscopicos, as lesoes SLAP foram inicialmente classificads em quatro tipos. Recente estudo acrescentou mais tres tipos para essa classificaçao, sendo as do tipo II as de maior incidencia. Foram observados ainda tres subtipos destas e relatados seus efeitos na biomecanica do ombro. Diversos mecanismos de lesao foram propostos e dois novos exames fisicos foram preconizados. Controversias existem quant ao melhor metodo de diagnostico por imagem, porem a certeza diagnsotica só pode ser possivel via artroscopica. È de interesse da fisioterapia estudar tais lesoes, pois sao relativamente novas no conhecimento ortopedico, com importantes repercussoes clinicas quando nao identificadas, constinuindo graves obstaculos á reabilitaçao.

Posterior subscapularis release combined with transfer of latissimus dorsi and teres major for treatment of shoulder internal rotation contracture secondary to Erb's plasy

Fifteen children complaining of internal rotation contracture of the shoulders after obstetrical palsy, their mean age was 8.3 years, were included in this study. The preoperative average abduction and external rotation were 70 and 50 degrees, respectively. All patients had subscapularis release from the scapula and transfer of latissimus dorsi and teres major to rotator cuff. At the final follow up, all patients had an improvement of abduction and external rotation. The mean active abduction was improved to 120 degrees postoperatively. The average postoperative external rotation was 57 degrees. Subscapularis release and Hoffer transfer improved the shoulder abduction and external rotation in cases of birth palsy. All patients noticed an improvement of their functional activities of daily living as well as cosmoses

Correlación clínica artrográfica, ultrasonográfica y quirúrgica en el diagnóstico de las lesiones del mango rotador del hombro / Clinical, arthrographic, ultrasonographic and surgical correlationship for diagnosis of injuries of the rotator cuff of the shoulder

Se presentaron 41 pacientes con diagnóstico clínico de síndrome doloroso subacromial, de los cuales en 27 se atribuyó a rotura del mango rotador. Todos los enfermos se estudiaron con artrografía y con ultrasonografía y en todos se realizó cirugía exploradora. La correlación fué la siguiente: el diagnóstico clínico-artrográfico-quirúrgico coincidión en 73.2% (30 pacientes), y el diagnístico clínico-ultrasonográfico-quirúrgico en 87% (36 enfermos).