Biceps Suspension Procedure for Treatment of Painful Inferior Glenohumeral Subluxation in Hemiparetic Patients

[Introduction][1] This article describes our biceps suspension procedure for painful inferior subluxation of the glenohumeral joint in hemiparetic patients. ![Figure][2] ![Figure][2] [Step 1: Position Patient and Expose the Biceps Tendon][3] Position the patient supine and expose the long head of the biceps tendon. ![Figure][2] [Step 2: Create Tunnel][4] Use a curet to connect holes drilled at the superior and inferior aspects of the lesser tuberosity. [Step 3: Prepare Biceps Tendon][5] Incise the tendon at the musculotendinous junction to preserve as much length of the biceps tendon as possible. ![Figure][2] ![Figure][2] [Step 4: Create Suspension][6] Create a loop with the tendon, and suture the distal end to the proximal end. [Step 5: Postoperative Protocol][7] Use a sling for three months, followed by active range-of-motion exercises. [Results][8] In summary, all patients noted pain relief after surgery, ten (of eleven) noted decreased deformity, and nine were “very satisfied” with the outcome. [What to Watch For][9] [Indications][10] [Contraindications][11] [Pitfalls & Challenges][12] [Introduction][1] This article describes our biceps suspension procedure for painful inferior subluxation of the glenohumeral joint in hemiparetic patients. ![Figure][2] ![Figure][2] [Step 1: Position Patient and Expose the Biceps Tendon][3] Position the patient supine and expose the long head of the biceps tendon. ![Figure][2] [Step 2: Create Tunnel][4] Use a curet to connect holes drilled at the superior and inferior aspects of the lesser tuberosity. [Step 3: Prepare Biceps Tendon][5] Incise the tendon at the musculotendinous junction to preserve as much length of the biceps tendon as possible. ![Figure][2] ![Figure][2] [Step 4: Create Suspension][6] Create a loop with the tendon, and suture the distal end to the proximal end. [Step 5: Postoperative Protocol][7] Use a sling for three months, followed by active range-of-motion exercises. [Results][8] In summary, all patients noted pain relief after surgery, ten (of eleven) noted decreased deformity, and nine were “very satisfied” with the outcome. [What to Watch For][9] [Indications][10] [Contraindications][11] [Pitfalls & Challenges][12] [1]: #sec-9 [2]: pending:yes [3]: #sec-10 [4]: #sec-11 [5]: #sec-12 [6]: #sec-13 [7]: #sec-14 [8]: #sec-15 [9]: #sec-16 [10]: #sec-17 [11]: #sec-18 [12]: #sec-19