Turkiye Klinikleri Orthopaedics and Traumatology - Special Topics

Omuz Problemlerine Yaklaşım Özel Sayısı
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Biseps Uzun Başı Sorunları
Lesions of the Long Head of the Biceps
Ulunay KANATLIa, Selda BAŞARb, Baybars ATAOĞLUa
aOrtopedi ve Travmatoloji AD, Gazi Üniversitesi Tıp Fakültesi,
bFizyoterapi ve Rehabilitasyon Bölümü, Gazi Üniversitesi Sağlık Bilimleri Fakültesi, Ankara
Turkiye Klinikleri J Orthop & Traumatol-Special Topics. 2014;7(4):61-8
Article Language: TR
ÖZET
Biseps uzun başı sorunları inflamatuar, instabilite veya travmatik kaynaklı primer ve sekonder biseps tenditi, kısmi veya total yırtıklar ve superior labrum anterior posterior lezyonları (SLAP) şeklinde karşımıza çıkmaktadır. Fizik muayene ve görüntüleme yöntemleri ile teşhis konulur. Fizik muayenede en belirgin bulgu omuz superior ve anterior bölgesindeki ağrıdır. İleri evrelerde fonksiyon kaybı görülür. Tedavi planı hastaya göre şekillendirilir. Akut ağrılarda konservatif tedavi yöntemleri denenmelidir. Biseps patolojilerinde cerrahi tedavi kararı verilirken 3-6 ay süren konservatif tedavinin başarısız olduğu durumlarda hastanın yaşı, aktivite düzeyi, tedaviden beklentileri, kliniği, fizik muayenesi, rehabilitasyona uyumu ve eşlik eden omuz patolojileri çok iyi değerlendirilmelidir. Cerrahi tedavide tendon debridmanı, biseps dekompresyonu veya tenotomi uygulanabilir. Tenodez ve tenotominin klinik sonuçları arasında fark yoktur. Genç, sporcu, aktif çalışan hastalarda tenodez, yaşlı, sedanter hastalarda ise tenotomi tercih edilmelidir.

Anahtar Kelimeler: Tendinopati; omuz ağrısı; tenodez; ortopedik prosedürler
ABSTRACT
Biceps long head problems encountered in the way of inflammatory, instability, or traumatic originated primary and secondary biceps tendinitis, partial or total tear and superior labrum anterior posterior lesions (SLAP). It is diagnosed by physical examination and imaging methods. On physical examination, the most obvious signs are pain in the anterior and superior shoulder region. Loss of function is seen in advanced stages of lesions. The treatment plan is structured take into account patient's symptoms. Conservative treatment should be tried in acute pain. In biceps pathology, while deciding surgical treatment patient's age, activity level, treatment expectations, clinics, physical examinations, compliance of rehabilitation, and concomitant shoulder pathology should be evaluated very well in the events 3-6 months of conservative treatment failed. Tendon debridement, biceps tenotomy or decompression may apply as surgical treatment. Clinical results of tenodesis and tenotomy is not different. Tenodesis should be preferred in young, athlete, active patients, if patients are elderly or sedentary, tenotomy should be preferred.

Keywords: Tendinopathy; shoulder pain; tenodesis; orthopedic procedures

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30.03.2014

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