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肱三头肌肌腱远侧止点及 3 种修复技术的生物力学分析。

The distal triceps tendon footprint and a biomechanical analysis of 3 repair techniques.

机构信息

Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut 06519, USA.

出版信息

Am J Sports Med. 2010 May;38(5):1025-33. doi: 10.1177/0363546509358319. Epub 2010 Mar 3.

Abstract

BACKGROUND

Anatomic repair of tendon ruptures is an important goal of surgical treatment. There are limited data on the triceps brachii insertion, footprint, and anatomic reconstruction of the distal triceps tendon.

HYPOTHESIS

An anatomic repair of distal triceps tendon ruptures more closely imitates the preinjury anatomy and may result in a more durable repair.

STUDY DESIGN

Descriptive and controlled laboratory studies.

METHODS

The triceps tendon footprint was measured in 27 cadaveric elbows, and a distal tendon rupture was created. Elbows were randomly assigned to 1 of 3 repair groups: cruciate repair group, suture anchor group, and anatomic repair group. Biomechanical measurement of load at yield and peak load were measured. Cyclic loading was performed for a total of 1500 cycles and displacement measured.

RESULTS

The average bony footprint of the triceps tendon was 466 mm2. Cyclic loading of tendons from the 3 repair types demonstrated that the anatomic repair produced the least amount of displacement when compared with the other repair types (P < .05). Load at yield and peak load were similar for all repair types (P > .05).

CONCLUSION

The triceps bony footprint is a large area on the olecranon that should be considered when repairing distal triceps tendon ruptures. Anatomic repair of triceps tendon ruptures demonstrated the most anatomic restoration of distal triceps ruptures and showed statistically significantly less repair-site motion when cyclically loaded.

CLINICAL RELEVANCE

Anatomic repair better restores preinjury anatomy compared with other types of repairs and demonstrates less repair-site motion, which may play a role in early postoperative management.

摘要

背景

肌腱断裂的解剖修复是手术治疗的重要目标。关于肱三头肌止点、足迹和远端肱三头肌腱的解剖重建,数据有限。

假设

对远端肱三头肌肌腱断裂进行解剖修复更能模拟损伤前的解剖结构,可能会产生更持久的修复效果。

研究设计

描述性和对照性实验室研究。

方法

在 27 个尸体肘部测量了肱三头肌腱的止点,并创建了远端肌腱断裂。肘部随机分为 3 种修复组之一:十字修复组、缝线锚定组和解剖修复组。测量屈服载荷和峰值载荷的生物力学。总共进行了 1500 次循环的循环加载,并测量了位移。

结果

肱三头肌腱的平均骨性止点面积为 466mm2。3 种修复类型的肌腱循环加载表明,与其他修复类型相比,解剖修复产生的位移最小(P<.05)。屈服载荷和峰值载荷在所有修复类型之间相似(P>.05)。

结论

肱三头肌骨性止点是鹰嘴骨上的一个大区域,在修复远端肱三头肌肌腱断裂时应考虑到这一点。对肱三头肌肌腱断裂进行解剖修复可最大程度地恢复远端肱三头肌断裂的解剖结构,并在循环加载时显示出统计学上显著更小的修复部位运动。

临床相关性

与其他类型的修复相比,解剖修复能更好地恢复损伤前的解剖结构,并且修复部位的运动也更少,这可能在术后早期管理中发挥作用。

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