上腕二頭筋長頭腱と共同腱の断裂を伴った上腕骨外科頚骨折の1例

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We report a case of rupture of the conjoined tendon and the long head of the biceps tendon accompanied by surgical neck fracture of humerus. To our knowledge, this is the first report of such an injury. A 77-year-old male fell down and he consulted a doctor nearby three days later and a surgical neck fracture of humerus was pointed out. He consulted us seven days later. In X-ray photos, a surgical neck fracture of humerus was identified with significant displacement of humeral shaft near the coracoid process. At first, we tried closed reduction but failed. On the next day open reduction and internal fixation were performed with delto-pectral approach. Rupture of the conjoined tendon and the long head of the biceps tendon was observed. Internal fixation was performed using T2 Nail (TM® Stryker) and non-absorbable rotator cuff-incorporating sutures. Tenodesis of the long head of the biceps tendon was performed and the conjoined tendon was repaired end to end fashion. Following surgery, the operated arm was immobilized in alter Desault bandage for three weeks. Sixteen months after surgery, bone union was confirmed on plain X-ray photos, functional results were good and the patient was completely free from pain and did not show any deformity of the upper arm. We should be aware of these tendon ruptures when we treat a surgical neck fracture of humerus with severe anterior or anteromedial displacement of the humeral shaft.