Rupture of the tendon of the biceps flexor cubiti : a case of rupture of the long tendon in its continuity, and one of rupture of the same tendon at the glenoid attachment : operation with successful result in each case / by William W. Keen.

  • William Williams Keen
Date:
[1905]
Catalogue details

Licence: In copyright

Credit: Rupture of the tendon of the biceps flexor cubiti : a case of rupture of the long tendon in its continuity, and one of rupture of the same tendon at the glenoid attachment : operation with successful result in each case / by William W. Keen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    its attachment to the rim of the glenoid cavity was also firm. I dissected under the deltoid for a short distance upward till I reached the groove in the head of the humerus. About two centi- metres below the groove began a fusiform swelling in the tendon extending downward about 1.5 centimetres (Fig. 2). This por- tion of the tendon was markedly discolored, almost black, evi- dently from blood effused within the sheath, but the sheath was intact. It was clear, therefore, that the tendon itself had been torn or ruptured within its sheath, and was much elongated, this partially destroying the function of the muscle. I severed the tendon just below the discolored portion, and, while each end was held taut overlapping the other about two centi- metres, I sutured the two ends together with twenty-day chromi- cized catgut (Fig. 2). The arm was then placed on a rectangu- lar splint so as to relax the biceps muscle. He went home, December 26, with the wound entirely healed. January 26, 1905. He called to see me to-day. The splint was worn for two weeks after the operation, and the forearm was carried in a sling for two weeks more. At the end of that time he tells me he began doing athletic “ stunts” with the arms, and has felt only the inconvenience which comes from weakness of the right biceps, due partially to non-use for a month. The muscular belly is quite flaccid as yet, and it is smaller than that on the right side by half a centimetre. The exercises he has taken have not been violent or prolonged, and presumably the biceps will improve very much in time. [March 31. He is now practically as well as ever. The de- formity of the biceps has almost disappeared.] Case II.—Dr. J. Chalmers Da Costa has kindly given me the following notes of his case: “ In May, 1904, a man, aged fifty- two years, while lifting a heavy bucket or pail, was suddenly seized with violent pain in the upper arm. He dropped the bucket, and for several days kept his arm bandaged and in a sling. I first saw him several days after the accident. Flexion of the forearm could be slowly executed, but was feeble, painful, and incomplete. On attempting flexion, the short head of the biceps contracted and the belly of the muscle became abnormally promi- nent, but the muscular ‘ bunch’ thus produced was flabby and nearer the elbow-joint than normal. An incision disclosed the long head of the biceps curved like a snake. When pulled upon,