scholarly journals Yergason's Test: Discrepancies in Description and Implications for Diagnosing Biceps Subluxation

2008 ◽  
Vol 3 (4) ◽  
pp. 143-147 ◽  
Author(s):  
Robert W. Pettitt ◽  
Scott R. Sailor ◽  
Gary Lentell ◽  
Cary Tanner ◽  
Steven R. Murray
Keyword(s):  
Biceps Tendon ◽  
Athletic Trainers ◽  
Instructional Materials ◽  
Positive Sign ◽  
Subscapularis Tendon ◽  
Bicipital Groove ◽  
Certification Examination ◽  
Wide Range ◽  
Long Head ◽  
Board Of Certification

Yergason described the case of a woman with bicipital pain that was confirmed with isolated forearm supination. Since publication of this respective case report in 1931, orthopedic assessment textbooks have provided a wide range of descriptions for Yergason's Test and what a positive sign implicates. Vast differences in hand placement, along with the vernacular for shoulder, forearm, and elbow motions, have been associated with Yergason's Test. Many authors associate pain with the maneuver as a diagnosis for a rupture of the transverse humeral ligament (THL) and subsequent subluxation of the long head of the biceps tendon (LBT). Interestingly, many now believe that the THL is not a distinct ligament; rather, support of the LBT within the bicipital groove occurs from a fibrous extension of the subscapularis tendon. Thus, evaluation of the subscapularis when a subluxing LBT is suspected is critical. The discrepancies of Yergason's Test among orthopedic assessment textbooks shall be summarized along with a brief review of contemporary views on how to clinically evaluate the subluxing LBT. Until consensus is reached on hand placement and joint movements to provoke subluxation of the LBT, Yergason's Test should be removed from instructional materials and the Board of Certification examination for athletic trainers, if applicable.

Predictive factors of long head of the biceps tendon disorders—the bicipital groove morphology and subscapularis tendon tear

2016 ◽  
Vol 25 (3) ◽  
pp. 384-389 ◽  
Author(s):  
Atsushi Urita ◽  
Tadanao Funakoshi ◽  
Toraji Amano ◽  
Yuichiro Matsui ◽  
Daisuke Kawamura ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Biceps Tendon ◽  
Subscapularis Tendon ◽  
Bicipital Groove ◽  
Tendon Tear ◽  
Subscapularis Tendon Tear ◽  
Long Head

scholarly journals Measurements of Tendon Movement Within the Bicipital Groove After Suprapectoral Intra-articular Biceps Tenodesis in a Cadaveric Model

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097753
Author(s):  
Brian J. Kelly ◽  
Alan W. Reynolds ◽  
Patrick J. Schimoler ◽  
Alexander Kharlamov ◽  
Mark Carl Miller ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Full Range ◽  
Elbow Flexion ◽  
Biceps Tenodesis ◽  
Bicipital Groove ◽  
Biceps Tenotomy ◽  
Flexion Extension ◽  
Before And After ◽  
Long Head ◽  
Scapular Motion

Background: Lesions of the long head of the biceps can be successfully treated with biceps tenotomy or tenodesis when surgical management is elected. The advantage of a tenodesis is that it prevents the potential development of a cosmetic deformity or cramping muscle pain. Proponents of a subpectoral tenodesis believe that “groove pain” may remain a problem after suprapectoral tenodesis as a result of persistent motion of the tendon within the bicipital groove. Purpose/Hypothesis: To evaluate the motion of the biceps tendon within the bicipital groove before and after a suprapectoral intra-articular tenodesis. The hypothesis was that there would be minimal to no motion of the biceps tendon within the bicipital groove after tenodesis. Study Design: Controlled laboratory study. Methods: Six fresh-frozen cadaveric arms were dissected to expose the long head of the biceps tendon as well as the bicipital groove. Inclinometers and fiducials (optical markers) were used to measure the motions of the scapula, forearm, and biceps tendon through a full range of shoulder and elbow motions. A suprapectoral biceps tenodesis was then performed, and the motions were repeated. The motion of the biceps tendon was quantified as a function of scapular or forearm motion in each plane, both before and after the tenodesis. Results: There was minimal motion of the native biceps tendon during elbow flexion and extension but significant motion during all planes of scapular motion before tenodesis, with the most motion occurring during shoulder flexion-extension (20.73 ± 8.21 mm). The motion of the biceps tendon after tenodesis was significantly reduced during every plane of scapular motion compared with the native state ( P < .01 in all planes of motion), with a maximum motion of only 1.57 mm. Conclusion: There was a statistically significant reduction in motion of the biceps tendon in all planes of scapular motion after the intra-articular biceps tenodesis. The motion of the biceps tendon within the bicipital groove was essentially eliminated after the suprapectoral biceps tenodesis. Clinical Relevance: This arthroscopic suprapectoral tenodesis technique can significantly reduce motion of the biceps tendon within the groove in this cadaveric study, possibly reducing the likelihood of groove pain in the clinical setting.

scholarly journals The influence of bicipital groove morphology on the stability of the long head of the biceps tendon

2017 ◽  
Vol 25 (2) ◽  
pp. 230949901771719 ◽  
Author(s):  
Jae Chul Yoo ◽  
Geethan Iyyampillai ◽  
Dongjun Park ◽  
Kyoung-Hwan Koh
Keyword(s):  
Biceps Tendon ◽  
Bicipital Groove ◽  
Long Head ◽  
The Stability

scholarly journals Functional anatomy of the superior glenohumeral and coracohumeral ligaments and the subscapularis tendon in view of stabilization of the long head of the biceps tendon

2010 ◽  
Vol 19 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Ryuzo Arai ◽  
Tomoyuki Mochizuki ◽  
Kumiko Yamaguchi ◽  
Hiroyuki Sugaya ◽  
Masahiko Kobayashi ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Functional Anatomy ◽  
Subscapularis Tendon ◽  
Long Head

scholarly journals Superior labrum almost always tears following subscapularis injuries

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0006
Author(s):  
Mehmet Çetinkaya ◽  
Muhammet Baybars Ataoğlu ◽  
Mustafa Özer ◽  
Tacettin Ayanoğlu ◽  
Ahmet Yiğit Kaptan ◽  
...  
Keyword(s):  
Shoulder Arthroscopy ◽  
Biceps Tendon ◽  
Slap Lesion ◽  
Subscapularis Tendon ◽  
Strongly Correlated ◽  
Subscapularis Tear ◽  
Slap Lesions ◽  
Superior Labrum ◽  
Medial Support ◽  
Long Head

Purpose and Hypothesis: The subscapularis tendon is the major medial support of the long head of biceps tendon (LHBT). Thus, tears of subscapularis may cause biceps tendon subluxation or dislocation. A subluxated biceps tendon may cause a superior labrum injury because of the changed direction of the biceps tendon pulling vector. The purpose of this study is to express the frequency of superior labrum anterior posterior (SLAP) lesions accompanying subscapularis tears. Methods: The digital files of 2010 patients who underwent shoulder arthroscopy were reviewed retrospectively. 141 videos of 141 patients with subscapularis tear were examined in terms of superior labrum and biceps tendon injuries by one of the authors in this study. The results were compared with those of all the 2010 patients who underwent shoulder arthroscopy for any reason. The statistical analysis was made with a statistics programme by the Independent Samples T-Test. Results: There were 113 videos on which the superior labrum and LHBT could be examined precisely. Mean age was 57.8 and 66% of the patients were female. 96.4% of the 113 patients were having a SLAP lesion. 10.6% of those were SLAP I and 89.4% were SLAP II lesion. Out of 2010 patients, the SLAP lesion ratio was 32.2% of which 4.9% were SLAP I. That difference between the patients with and without subscapularis tear was statistically significant. Conclusions: Following the loss of medial support, the LHBT and its pulling vector subluxate anteriorly resulting in a tear of the superior labrum from anterior to posterior. In this study, SLAP lesions were strongly correlated with subscapularis tears as well. Furthermore, the synovial hypertrophy initiated after a superior labrum pathology at superior aspect of the glenoid spreads over the LHBT. An inflamed LHBT firstly degenerates, and then ruptures. According to this study, tears of subscapularis should be repaired when encountered in order to prevent the upcoming secondary intra-articular disorders. [Figure: see text]

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