Kragh John F, Basamania Carl J
Orthopaedic Service, Department of Orthopaedics and Rehabilitation, Womack Army Medical Center, Fort Bragg, North Carolina, USA.
J Bone Joint Surg Am. 2002 Jun;84(6):992-8. doi: 10.2106/00004623-200206000-00014.
Effective techniques to repair transected muscles are not well described. We determined the outcome of surgically repaired closed transections of the biceps muscle with regard to strength, appearance, and patient satisfaction.
We conducted a study on surgical repair of acute traumatic closed transection of the muscle belly of the biceps brachii in paratroopers. Muscle fibers and epimysium were sutured with use of running interlocked stitches as well as modified Mason-Allen stitches. We gathered data on the supination torque, appearance of the arm, and patient satisfaction. Nine patients underwent surgical repair and were followed for a mean of 2.2 years. Three patients, who constituted a comparative group, had nonoperative treatment of complete transections of the biceps and were followed for a mean of eleven years.
We found that the patients who had surgical repair had better results than did those who had nonoperative treatment, with respect to supination torque (a mean of 11.0 N-m compared with 5.8 N-m, p = 0.0005), appearance (a mean of 4.6 cm compared with 3.0 cm, according to the cosmetic visual analog scale; p = 0.000002), and satisfaction (excellent in all nine patients who had surgical repair and satisfactory in all three who had nonoperative treatment).
The results after repair of acute traumatic closed transection of the biceps brachii with the new surgical technique described in the present study demonstrated a significant improvement in terms of function, appearance, and patient satisfaction compared with those after nonoperative treatment.
修复横断肌肉的有效技术尚未得到充分描述。我们确定了手术修复肱二头肌闭合性横断伤在力量、外观和患者满意度方面的结果。
我们对伞兵肱二头肌肌腹急性创伤性闭合性横断伤的手术修复进行了一项研究。使用连续连锁缝合以及改良的梅森-艾伦缝合来缝合肌纤维和肌外膜。我们收集了旋后扭矩、手臂外观和患者满意度的数据。9例患者接受了手术修复，平均随访2.2年。3例患者组成对照组，肱二头肌完全横断伤接受非手术治疗，平均随访11年。
我们发现，手术修复的患者在旋后扭矩（平均11.0牛米，而非手术治疗组为5.8牛米，p = 0.0005）、外观（根据美容视觉模拟量表，平均4.6厘米，而非手术治疗组为3.0厘米；p = 0.000002）和满意度（9例接受手术修复的患者均为优秀，3例接受非手术治疗的患者均为满意）方面的结果优于非手术治疗的患者。
与非手术治疗相比，本研究中描述的新手术技术修复肱二头肌急性创伤性闭合性横断伤后的结果在功能、外观和患者满意度方面有显著改善。
