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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 | Update Article
Ombro e Cotovelo

Lesões agudas do tendão distal do bíceps: Diagnóstico e tratamento

Artikel in mehreren Sprachen: português | English
Luiz Henrique Boraschi Vieira Ribas 
1   Aluno 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
2   Médico ortopedista, especialista em Ombro e Cotovelo, Instituto Vita, São Paulo, SP, Brasil
,
Breno Schor 
2   Médico ortopedista, especialista em Ombro e Cotovelo, Instituto Vita, São Paulo, SP, Brasil
,
Geraldo da Rocha Motta Filho 
3   Médico ortopedista, especialista em Ombro e Cotovelo, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil
,
Paulo Santoro Belangero 
4   Cirurgião ortopçdico, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
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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


Publikationsverlauf

Eingereicht: 04. Juni 2022

Angenommen: 12. April 2023

Artikel online veröffentlicht:
30. Oktober 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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