Simultaneous Acute Rotator Cuff Tear and Distal Biceps Rupture in a Strongman Competitor
George MS. “Simultaneous Acute Rotator Cuff Tear and Distal Biceps Rupture in a Strongman Competitor”. Orthopedics 2010; 16:268-270
Abstract
Acute rotator cuff tear is commonly associated with tearing of the proximal
biceps tendon, but has never been reported to occur simultaneously with a
distal biceps tendon rupture. A 38-year-old right-hand-dominant strongman competitor
attempted a 300-pound overhead axle press and experienced immediate pain in the
right shoulder and elbow. He had no known systemic risk factors for tendon
ruptures including hyperparathyroidism, hemodialysis, alcoholism, rheumatoid
arthritis, statin medications, fluoroquinolones, and steroid use.Right shoulder
magnetic resonance imaging (MRI) showed a full-thickness supraspinatus tear
with 3 cm of retraction. There was minimal fatty infiltration of the
supraspinatus on the sagittal cuts consistent with acute rupture. The
subscapularis was intact. The long head of the biceps tendon had mild medial
subluxation but was completely within the bicipital groove. Right elbow MRI
showed a complete distal biceps tendon rupture. Thirteen days after his injury,
the patient underwent arthroscopic supraspinatus repair and proximal biceps
tenodesis. Distal biceps tendon repair was performed using the modified
2-incision muscle-splitting technique. At 24-month follow-up, the patient was
pain free and had returned to full activity including weightlifting but had not
returned to strongman competition.This is the first report of simultaneous
acute full thickness ruptures of the rotator cuff and distal biceps tendon.
This case report underscores the importance of a complete physical examination
and a high index of suspicion for additional concomitant injuries, particularly
in athletes with unusually high stresses to the body.
Copyright 2010, SLACK Incorporated.
