Western Orthopaedic, Subiaco, WA, Australia.
J Shoulder Elbow Surg. 2012 Jan;21(1):61-5. doi: 10.1016/j.jse.2011.01.014. Epub 2011 Mar 30.
Long head of biceps brachii tenotomy is well accepted by patients and the procedure has comparable outcomes in younger manually active and older sedentary populations.
A total of 117 individuals at least 12 months after tenotomy of the long head of biceps brachii attended for review. Typical of clinical practice, in only one patient was the tenotomy performed in isolation. Interviews, clinical examination, and strength testing were performed to determine the rates of (1) cosmetic deformity, (2) cramping pain in the biceps muscle, (3) weakness, and (4) patient satisfaction.
There was no significant difference between the younger manually active and the older sedentary groups in measures of cramping, weakness, or deformity, and 95% of patients were satisfied or very satisfied with the outcome of their surgery. Three percent of patients were concerned with deformity but none requested correction. Objective testing found no statistical difference in elbow flexion or forearm supination strength between the operated-on and nonoperated-on sides. Nineteen percent of patients reported cramping sensations.
This study demonstrated similar rates of adverse effects to previous tenotomy studies in cramping sensations, strength deficits, and cosmetic deformity. It demonstrated that results are similar in older sedentary and younger manually active patients and are comparable to the alternative, tenodesis.
Biceps tenotomy is well accepted by most patients with good overall results. Some adverse effects occur but appear to be mild and of little concern to patients. The procedure is tolerated in manually active populations.
肱二头肌长头肌腱切断术被患者广泛接受,且该手术在年轻的手动活动人群和年长的久坐人群中具有相当的效果。
共有 117 名患者在肱二头肌长头肌腱切断术后至少 12 个月接受了随访。与临床实践典型情况一样,只有 1 名患者接受了孤立的肌腱切断术。通过访谈、临床检查和力量测试,确定了以下情况的发生率:(1)美容畸形,(2)肱二头肌肌肉痉挛性疼痛,(3)无力,以及(4)患者满意度。
在痉挛、无力或畸形等方面,年轻的手动活动人群和年长的久坐人群之间没有显著差异,95%的患者对手术结果感到满意或非常满意。有 3%的患者对畸形感到担忧,但无人要求矫正。客观测试发现,手术侧和非手术侧的肘部弯曲和前臂旋前力量无统计学差异。19%的患者报告有痉挛感。
本研究显示,在痉挛感、力量缺陷和美容畸形等不良影响方面,与先前的肌腱切断术研究结果相似。它表明,在年长的久坐人群和年轻的手动活动人群中,结果相似,并且与替代的肌腱固定术相当。
肱二头肌肌腱切断术被大多数患者广泛接受,总体效果良好。一些不良影响确实存在,但似乎轻微,且患者并不关注。该手术在手动活动人群中可耐受。