Biceps long head tendon revisited: a case report of split tendon arising from single origin

A 27-year-old, right-hand-dominant woman with a posttraumatic anterior shoulder dislocation 3 months earlier after traffic accident presented because of pain and limited range of motion in the right shoulder. On physical examination, the patient had negative instability tests and a sulcus sign. On arthroscopic examination, a bifurcate long biceps tendon with two limbs was observed about 1 cm distal to the origin in the supraglenoid tubercle. We found no evidence of a tear in the long biceps tendon on probing, and the margin of each limb was smooth and round. Although this anatomic variant may be benign, its presence might be associated with other shoulder pathology. It is interesting to speculate whether the aberrant biceps anatomy in our patient contributed to transfer of injury at dislocation to the rotator cuff rather than to the classic anterior-inferior capsulolabral complex. In addition, recognition of the described anatomic variant on arthroscopy can aid the shoulder surgeon in focusing treatment on the actual pathology.