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Keywords:
Musculoskeletal joint, Ultrasound, Instrumentation, Trauma
Authors:
G. Azulay1, I. Rossi1, M. Brandao2, C. Arend3, R. Barousse1, D. Postan1, P. Omoumi4; 1Buenos Aires/AR, 2Ribeirao Preto/BR, 3Porto Alegre/BR, 4Lausanne/CH
DOI:
10.1594/ecr2014/B-0042
Purpose
Demonstrate the feasibility and to assess the diagnostic value of a dynamic ultrasound manoeuvre for the diagnosis of complete vs.
partial tears of the distal biceps tendon at the elbow.
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•The majority of the maneuvers used till now to evaluate the distal biceps tendon are based on the direct visualization of the tendon in it´s insertion portion in the radial tuberosity.
(Fig.
1)•The elongation and horizontalization of the muscle fibers are the fundamentals of these maneuvers (Fig.2)•The “Cobra” maneuver is the only maneuver that shows the distal biceps tendon during a pronation/supination movement. (Fig.
3)
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NEW MANEUVER •We took into account two properties of the Biceps Brachii Muscle 1.The pronation/supination movements of the biceps brachii muscle2.The displacement of the tendon in the axial plane due to the transmission of motion,
showing the indemnity of the insertion of the distal biceps tendon in the radial tuberosity without evaluating the area of the radial tuberosity itself.
Fig. 4: Ultrasound image in supination showing the biceps tendon and its position in relation to the humeral vessels and the median nerve.
Fig. 5: Ultrasound image in supination showing the biceps tendon and its position in relation to the humeral vessels and the median nerve. The biceps tendon in supination it descends and gets near the humeral vessel and the median nerve.
Fig. 6: Ultrasound image in showing how the biceps tendon changes its position, in relation to the humeral vessels and the median nerve, while it moves from supination to pronation.
Fig. 7: Ultrasound image in pronation showing the biceps tendon and its position in relation to the humeral vessels and the median nerve. The biceps tendon in pronation moves away and puts itself in a horizontal position
Fig. 8: Ultrasound image in pronation showing the biceps tendon and its position in relation to the humeral vessels and the median nerve. The biceps tendon in pronation moves away and puts itself in a horizontal position