Kokkalis Zinon T, Ballas Efstathios G, Mavrogenis Andreas F, Soucacos Panayotis N
Department of Orthopaedics, Orthopaedic Research & Education Center, National and Kapodistrian University of Athens, School of Medicine, "Attikon" University Hospital, Athens, Greece.
Department of Orthopaedics, Orthopaedic Research & Education Center, National and Kapodistrian University of Athens, School of Medicine, "Attikon" University Hospital, Athens, Greece.
Injury. 2013 Mar;44(3):318-22. doi: 10.1016/j.injury.2013.01.003. Epub 2013 Jan 23.
Biceps and triceps tendon ruptures are rather uncommon injuries and are most commonly diagnosed clinically. Magnetic resonance imaging can help the clinician to differentiate an incomplete tear and define any degeneration of the tendon. Surgical anatomical repair is typically performed in acute complete ruptures whereas nonoperative treatment can be used for partial ruptures, as well as for patients unfit for surgery. Single incision techniques are associated with a higher rate of nerve injuries, while double incision repairs have a higher prevalence of heterotopic ossification. Although various fixation methods have been applied including bone tunnels, interference screws, suture anchors, cortical button fixation, the current evidence does not support the superiority of one method over the other. A well-planned postoperative rehabilitation programme is essential for a good final outcome. As better fixation devices are being used, more aggressive rehabilitation programmes have been applied. Epidemiology, clinical evaluation, diagnosis, surgical and conservative management of these injuries are presented in this review along with the authors' preferred technique for the anatomical repair of acute complete ruptures.
肱二头肌和肱三头肌腱断裂是相当罕见的损伤,最常通过临床诊断。磁共振成像有助于临床医生区分不完全撕裂并确定肌腱的任何退变情况。急性完全断裂通常进行手术解剖修复,而部分断裂以及不适合手术的患者可采用非手术治疗。单切口技术与较高的神经损伤发生率相关,而双切口修复的异位骨化发生率较高。尽管已应用了各种固定方法,包括骨隧道、干涉螺钉、缝合锚钉、皮质纽扣固定,但目前的证据并不支持一种方法优于另一种方法。精心规划的术后康复计划对于取得良好的最终结果至关重要。随着使用更好的固定装置,已采用了更积极的康复计划。本综述介绍了这些损伤的流行病学、临床评估、诊断、手术和保守治疗,以及作者首选的急性完全断裂解剖修复技术。