Sanchez-Sotelo Joaquin, Morrey Bernard F, Adams Robert A, O'Driscoll Shawn W
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Bone Joint Surg Am. 2002 Jun;84(6):999-1005. doi: 10.2106/00004623-200206000-00015.
Chronic ruptures of the distal biceps tendon are uncommon and are complicated by the retraction and poor quality of the muscle and tendon. Surgical procedures that have been described for the treatment of this injury are limited by the quality and availability of the structures used for augmentation. The purpose of the present study was to describe the surgical technique for reconstruction of the tendon with an Achilles tendon allograft and to report our preliminary experience with this procedure.
An Achilles tendon allograft was used to reconstruct a chronic rupture of the distal biceps tendon in four patients. The patients were evaluated with regard to subjective satisfaction, pain, range of motion, and strength in flexion and supination. The results were graded with use of the Mayo elbow performance score.
After an average duration of follow-up of 2.8 years (range, 2.0 to 3.7 years), all four patients had a satisfactory subjective result, a full range of motion, and an excellent Mayo elbow performance score. The strength of flexion and supination was comparable with that on the contralateral side in two patients and was slightly decreased in the other two.
Reconstruction of chronic disruptions of the distal biceps tendon with an Achilles tendon allograft appears to offer a satisfactory technical solution for this challenging problem and has provided satisfactory clinical results to date.
肱二头肌远端肌腱慢性断裂并不常见，且因肌肉和肌腱回缩以及质量欠佳而变得复杂。已描述的用于治疗该损伤的手术方法受到用于增强的结构的质量和可用性的限制。本研究的目的是描述使用跟腱同种异体移植物重建肌腱的手术技术，并报告我们在此手术中的初步经验。
使用跟腱同种异体移植物重建4例患者的肱二头肌远端肌腱慢性断裂。对患者进行主观满意度、疼痛、活动范围以及屈曲和旋后力量方面的评估。结果采用梅奥肘关节功能评分进行分级。
平均随访2.8年（范围为2.0至3.7年）后，所有4例患者主观结果均令人满意，活动范围正常，梅奥肘关节功能评分优秀。2例患者的屈曲和旋后力量与对侧相当，另外2例略有下降。
用跟腱同种异体移植物重建肱二头肌远端肌腱慢性断裂似乎为这个具有挑战性的问题提供了一种令人满意的技术解决方案，并且迄今为止已取得了令人满意的临床结果。
