Posterior dislocation of the long head of biceps tendon: case report and review of the literature

Abstract

Posterior or lateral dislocation of the long head of biceps is a rare complication of shoulder dislocation that can result in inability to relocate the humerus. The diagnosis should be suspected when certain radiographic features are present at the initial presentation. Other imaging modalities can aid diagnosis when clinical management is unsuccessful or protracted. We present a case of surgically proven posterior dislocation of the biceps tendon with conventional radiographic, computed tomography and magnetic resonance imaging assessment. The literature on this subject is reviewed, and imaging features associated with the diagnosis are described.

Rare case of intra-articular biceps incarceration following traumatic massive rotator cuff tear

“…As such, most of these injuries occur in a traumatic setting, normally in conjunction with an extensive RCT, or a humerus fracture dislocation. 7 , 9 , 10 , 12 …”

Irreducible Traumatic Anterior Shoulder Dislocation Secondary to Both Subscapularis and Long Head of Biceps Tendon Interposition—A Case Report

“…When the subscapularis tendon is ruptured the biceps tendon can dislocate medially and also interpose in the joint. For a postero-lateral dislocation of the long head of biceps tendon to occur, lateral stabilising structures of the rotator cuff need to be deficient also [8,9]. This lack of lateral restraint then allows the biceps tendon to move around the lateral margin of the humerus, and into the posterior aspect of the glenohumeral joint.…”

“…In our case, a shoulder dislocation combined with a massive rotator cuff tear allowed the tendon to dislocate. Other studies have shown posterior dislocation of the long head of biceps tendon into the shoulder joint [4,5,9,10], but due to the rarity of this condition, the literature is limited to sporadic case reports.…”

Irreducible anterior and posterior dislocation of the shoulder due to incarceration of the biceps tendon

“…[3–11] In five of the nine cases, a greater tuberosity fracture allowed posterior/lateral subluxation of the biceps tendon. [5781011] Two of the nine cases were identified with a Hill-Sachs defect,[38] and three of the nine cases showed no bony lesions (other than the ectopic calcification reported by Freeland and Higgins and Rakofsky et al .). [469]…”

“…[18–20] Imaging techniques such as arthrography, computed tomography (CT) and magnetic resonance imaging (MRI) provide crucial adjuncts to conventional radiography by allowing identification of the obstacle to reduction and appropriate planning of operative intervention. [8] We present a case of irreducible anterior glenohumeral dislocation resulting from an initial anterior dislocation, which was converted to a posterior dislocation with an attempt at reduction, then converted back to an anterior dislocation with a second reduction attempt. To our knowledge, only three other case reports exist providing CT imaging with surgical correlation of an interposition of the biceps tendon between the humeral head and glenoid,[389] with none reporting this finding secondary to iatrogenic conversion of anterior dislocation to a posterior dislocation during reduction, secondary to biceps incarceration in the glenohumeral joint.…”