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一种使用软组织纽扣和生物固定干涉螺钉进行肱二头肌远端修复的联合技术。

A combined technique for distal biceps repair using a soft tissue button and biotenodesis interference screw.

作者信息

Heinzelmann Andrew D, Savoie Felix H, Ramsey J Randall, Field Larry D, Mazzocca Augustus D

机构信息

Mississippi Sports Medicine and Orthopaedic Center, 1325 E Fortification St, Jackson, MS 39202, USA.

出版信息

Am J Sports Med. 2009 May;37(5):989-94. doi: 10.1177/0363546508330130. Epub 2009 Apr 3.

Abstract

BACKGROUND

There are many techniques described to repair acute distal biceps tendon ruptures. The authors' objective is to report the results of a single-incision technique using a combination of a soft tissue button and biotenodesis interference screw with accelerated rehabilitation.

HYPOTHESIS

Dual fixation of a distal biceps rupture will allow for early return to function.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

From February 2004 to July 2007, 41 elbows in 40 patients had repair of an acute distal biceps tendon rupture (<6 weeks) through an anterior incision using a soft tissue button and interference screw combined technique. The patients were evaluated pre- and postoperatively with a physical examination, radiographs, and the Andrews-Carson elbow score. Nine patients were unavailable for follow-up. The remaining 31 patients (32 elbows) were contacted for a telephone interview at an average of 24 months postoperatively.

RESULTS

The preoperative Andrews-Carson score averaged 168 and the postoperative Andrews-Carson score averaged 196 points at final clinical follow-up. There was a statistically significant difference between the pre- and postoperative Andrews-Carson scores (P < .001). One patient had heterotopic ossification associated with decreased pronation and supination. Two superficial radial nerve palsies completely resolved by final follow-up. The average postoperative time to resume normal activities or return to work was 6.5 weeks.

CONCLUSION

Repair of acute distal biceps tendon ruptures using a soft tissue button and interference screw technique through a limited anterior incision can allow for accelerated rehabilitation and early return to function.

摘要

背景

已有多种技术用于修复急性肱二头肌远端肌腱断裂。作者的目的是报告一种单切口技术的结果,该技术联合使用软组织纽扣和生物固定干涉螺钉,并采用加速康复方案。

假设

肱二头肌远端断裂的双重固定将允许早期恢复功能。

研究设计

病例系列;证据等级,4级。

方法

2004年2月至2007年7月,40例患者的41个肘部通过前切口采用软组织纽扣和干涉螺钉联合技术修复急性肱二头肌远端肌腱断裂(<6周)。术前和术后通过体格检查、X线片及安德鲁斯 - 卡森肘关节评分对患者进行评估。9例患者无法进行随访。其余31例患者(32个肘部)在术后平均24个月接受电话随访。

结果

末次临床随访时,术前安德鲁斯 - 卡森评分平均为168分,术后平均为196分。术前和术后安德鲁斯 - 卡森评分之间存在统计学显著差异(P < .001)。1例患者出现异位骨化,伴有旋前和旋后功能减退。2例桡浅神经麻痹在末次随访时完全恢复。术后恢复正常活动或重返工作的平均时间为6.5周。

结论

通过有限的前切口采用软组织纽扣和干涉螺钉技术修复急性肱二头肌远端肌腱断裂,可实现加速康复并早期恢复功能。

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