Case Reports in Orthopedics / 2019 / Article / Tab 1

Case Report

Traumatic Closed Proximal Muscle Rupture of the Biceps Brachii in Military Paratrooper

Table 1

The table demonstrates the published studies regarding the traumatic intrasubstance rupture of the biceps brachii, the type of treatment, and their results.

StudyTreatmentOutcome

Conwell [11]Open, debridement, no repair, splintingGood outcome reported
Gilcrest [10]Surgical repair with primary reattachment using catgut suture and fascial flapUnreported
Tobin et al. [12]UnreportedUnreported
Heckman & Levine [1]Nonoperative group: hematoma aspiration, splinting for 6 weeks in acute flexion. Operative group: open, debridement, primary repair, splinted in acute flexation for 4 weeks, then 90° flexation for 2 weeks, followed by gentle ROM53% return of elbow flexion in the nonoperative group vs. 76.5% in the operative group. One wound infection was reported. No complications in the nonoperative group
Mellen [13]Open, exploration, hematoma evacuation, excision of intraluminal thrombus, brachial artery grafting and repair, no biceps repair performedSkin breakdown and superficial wound infection reported. Visible and palpable defect persisted
DiChristina & Lustig [7]Open, primary repair, 3 weeks in splintFull ROM, 5/5 strength at 4 months
Bricknell [14]Closed, 4 weeks in slingVisible and palpable defect persisted, no functional deficit compared to contralateral side
Balkissoon et al. [15]NonoperativeUnreported
Craig & Lee [3]UnreportedUnreported
Kragh & Basamania [6]Nonoperative: sling & NSAIDs. Operative: open, debridement, primary repair, 3-5 day immobility followed by dynamic splinting with extension limited to 30° with early active ROMAll patients returned to full ROM. No complications, job changes, or poor functional outcomes reported. Patients disliked the Popeye deformity. Nonoperative patients regained 65% of contralateral supination/flexion compared with 89% of those repaired operatively
Shah & Pruzansky [9]Open, debridement, primary repair, postoperative splinting for 4 weeks, followed by hinged bracing for 6 weeksFull ROM, 5/5 strength at 5 months
Carmichael et al. [8]Open, debridement, no repairFull ROM, 5/5 strength at 8 months
Chen & Chew [16]Nonoperative, cast immobilization for 6 weeks in hyperflexed supinated positionSatisfactory cosmetic and functional results were reported

NSAIDs: nonsteroidal anti-inflammatory drugs, ROM: range of motion.

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