Fogg Quentin A, Hess Benjamin R, Rodgers K Gary, Ashwood Neil
Laboratory of Human Anatomy, Faculty of Biomedical and Life Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom.
Clin Anat. 2009 Apr;22(3):346-51. doi: 10.1002/ca.20786.
The distal biceps brachii tendon is commonly susceptible to traumatic injury. This study aimed to describe the morphology of the distal biceps brachii tendon in relation to the commonly used endobutton repair of tendon rupture. The results suggested that the distal tendon is a series of distinct bands of variable number. These bands are obscured surgically by the tendon sheath. Upon opening this sheath, blunt dissection of the tendon released fibrous connections between the tendon bands. Adjacent bands were variably connected via small oblique bands. The separations between bands were continuous onto the radius. They were therefore considered as separate force-conducting units. This notion is of high relevance to endobutton repairs, as the sutures are typically only passed through the margins of the tendon. Where few connections exist between tendinous bands, this represents a potential weakness, as central bands are therefore free to be pulled proximally. This is of primary concern in the early rehabilitative stages of postoperative care. It may be suggested that sutures that cross the width of the tendon will eliminate the give of central bands, improving postoperative results, reducing revision numbers, and potentially reducing rehabilitation time.
肱二头肌远端肌腱通常易受创伤性损伤。本研究旨在描述肱二头肌远端肌腱的形态与常用的肌腱断裂纽扣修复术的关系。结果表明，远端肌腱是一系列数量可变的不同束带。这些束带在手术中被腱鞘遮挡。打开腱鞘后，钝性分离肌腱可释放肌腱束带之间的纤维连接。相邻束带通过小斜带以不同方式相连。束带之间的间隙在桡骨上是连续的。因此，它们被视为独立的力传导单元。这一概念与纽扣修复术高度相关，因为缝线通常仅穿过肌腱边缘。肌腱束带之间连接较少的地方，这代表着一个潜在的弱点，因为中央束带因此可以自由地向近端牵拉。这在术后护理的早期康复阶段是首要关注的问题。可以认为，穿过肌腱宽度的缝线将消除中央束带的弹性，改善术后效果，减少翻修次数，并可能缩短康复时间。
