Lesions of the biceps pulley: a prospective study and classification update
ESSKA Academy. Martetschlager F. 11/08/19; 284403; epESA-06
Frank Martetschlager
Frank Martetschlager
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Lesions of the biceps pulley: a prospective study and classification update

ePoster - epESA-06

Topic: Other Surgical Options

Martetschlager F., Zampeli F., Tauber M., Habermeyer P.
Deutsches Schulterzentrum, ATOS Klinik Munchen, Munich, Germany

Background: The purpose of the study was to analyze 100 consecutive pulley lesions and to categorize the anatomic structures that are affected to investigate whether all lesions can be classified according to the Habermeyer classification system.
Methods: One hundred consecutive patients with pulley lesions were prospectively included in this study. During arthroscopy any lesions of the superior glenohumeral ligament (SGHL), medial/lateral coracohumeral ligament (MCHL/LCHL) and adjacent rotator cuff were recorded. The lesions were classified according to Habermeyer classification. Chi-squared test were used for statistical analysis (α=0.05).
Results: There were 3 lesions categorized as group 1, 20 as group 2, 6 lesions as group 3, and 35 lesions of group 4 according to Habermeyer classification, while 36 lesions were not classifiable due to absent of SGHL lesion. 95% of patients showed a lateral pulley sling lesion (LCHL), 64% a medial pulley sling (MCHL/SGHL) lesion, 5% isolated lesion of MCHL/SGHL, 36% isolated lesion of LCHL, and 59% lesions of both medial and lateral slings. Lesions of both medial and lateral pulley slings were related with complete subscapularis tears (.000).
Conclusion: The lateral pulley sling (LCHL) is more often affected than the medial sling (MCHL/SGHL), the SGHL is not always affected and isolated lesions of the medial sling are rare. Lesions of both medial and lateral slings showed higher frequency of concomitant complete subscapularis tear. An updated classification for direct pulley sling lesion is proposed: type 1, lesion of the medial pulley (MCHL/SGHL); type 2, lesion of the lateral pulley (LCHL); type 3, lesion of the medial and lateral pulley. Concomitant lesions to the indirect pulley stabilizers (rotator cuff fibers) can be mentioned additionally.
Lesions of the biceps pulley: a prospective study and classification update

ePoster - epESA-06

Topic: Other Surgical Options

Martetschlager F., Zampeli F., Tauber M., Habermeyer P.
Deutsches Schulterzentrum, ATOS Klinik Munchen, Munich, Germany

Background: The purpose of the study was to analyze 100 consecutive pulley lesions and to categorize the anatomic structures that are affected to investigate whether all lesions can be classified according to the Habermeyer classification system.
Methods: One hundred consecutive patients with pulley lesions were prospectively included in this study. During arthroscopy any lesions of the superior glenohumeral ligament (SGHL), medial/lateral coracohumeral ligament (MCHL/LCHL) and adjacent rotator cuff were recorded. The lesions were classified according to Habermeyer classification. Chi-squared test were used for statistical analysis (α=0.05).
Results: There were 3 lesions categorized as group 1, 20 as group 2, 6 lesions as group 3, and 35 lesions of group 4 according to Habermeyer classification, while 36 lesions were not classifiable due to absent of SGHL lesion. 95% of patients showed a lateral pulley sling lesion (LCHL), 64% a medial pulley sling (MCHL/SGHL) lesion, 5% isolated lesion of MCHL/SGHL, 36% isolated lesion of LCHL, and 59% lesions of both medial and lateral slings. Lesions of both medial and lateral pulley slings were related with complete subscapularis tears (.000).
Conclusion: The lateral pulley sling (LCHL) is more often affected than the medial sling (MCHL/SGHL), the SGHL is not always affected and isolated lesions of the medial sling are rare. Lesions of both medial and lateral slings showed higher frequency of concomitant complete subscapularis tear. An updated classification for direct pulley sling lesion is proposed: type 1, lesion of the medial pulley (MCHL/SGHL); type 2, lesion of the lateral pulley (LCHL); type 3, lesion of the medial and lateral pulley. Concomitant lesions to the indirect pulley stabilizers (rotator cuff fibers) can be mentioned additionally.
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