Isolated rupture of short head of biceps is a rare injury. There have been no published reports of rupture at the musculotendinous junction. We report two cases of complete rupture of the musculotendinous junction of the short head of biceps in young males both occurring during water skiing. Two males sustained water skiing injuries where the handle was forced against the flexor region of the arm. Whilst trying to adduct and flex the extended arm, they both sustained complete musculotendinous ruptured of their short head of biceps. Both underwent pre-operative magnetic resonance imaging and one underwent isokinetic strength testing of elbow flexion and supination. Surgical repair was performed using absorbable sutures. One patient had the short head muscle belly flipped distally to lie in a subcutaneous plane in front of the elbow. Post-operative management included cast immobilisation for three weeks then gentle range of motion exercises. Both patients recovered their full range of motion in the arm. There were no complications. Post-operative strength testing was performed and will be presented. This is a unique series of complete musculotendinous rupture of the short head of biceps. The mechanism of injury was resisted adduction and flexion against the towrope handle with the arm in extension. These ruptures occurred in high impact high velocity accidents. Surgical repair lead to an excellent outcome.
We describe five patients, seen since 1984, with posterior shoulder pain and isolated wasting and weakness of the infraspinatus. In four of these a ganglion in the spinoglenoid notch was demonstrated by MRI and in one recent case ultrasound scans were positive. Three patients have been treated by operation, but there was recurrence in one after five years. In each confirmed case, the ganglion straddled the base of the spine of the scapula, extending into both supraspinatus and infraspinatus fossae. The nerve was either compressed against the spine or stretched over the posterior aspect of the ganglion. Adequate surgical exposure is essential to preserve the nerve to the infraspinatus and to allow complete removal of the ganglion. This is difficult because of the location and thin-walled nature of the cysts.
