Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
J Shoulder Elbow Surg. 2014 Jun;23(6):850-4. doi: 10.1016/j.jse.2014.02.006. Epub 2014 Apr 26.
Distal biceps tendon rupture is a common injury, and primary repair results in excellent return of function and strength. Complications resulting from distal biceps tendon repairs are well reported, but the incidence of re-ruptures has never been investigated.
A search of the Mayo Clinic's Medical/Surgical Index was performed, and all distal biceps tendon repairs from January 1981 through May 2009 were identified. All patients who completed 12 months or more of follow-up were included. All charts were reviewed and patients contacted as necessary to identify a re-rupture. We also investigated the situation causing the re-rupture.
We identified a total of 190 distal biceps tendon ruptures that underwent repair and met our inclusion and exclusion criteria. Of the 190 repairs, 172 (90.5%) were performed by the Mayo modification of the Boyd-Anderson 2-incision technique. Bilateral ruptures occurred in 13 patients (7.3%). Six primary ruptures (3.2%) occurred in women, 4 of the 6 being partial ruptures. Partial ruptures were found to be statistically more common than complete ruptures in women (P = .05). We identified 3 re-ruptures (1.5%), all occurring within 3 weeks of the index surgery.
The re-rupture rate after primary repair of the distal biceps tendon is low at 1.5% and occurs within 3 weeks of index repair. This appears to be due to patient compliance and excessive force placed on repairs. We also found the incidence of women who sustain a distal biceps tendon tear to be 3.2%, with partial tears being statistically more common than complete ruptures.
Level IV, case series, treatment study
肱二头肌远端肌腱断裂是一种常见的损伤,初次修复可使功能和力量得到极好的恢复。肱二头肌远端肌腱修复的并发症已有详细报道,但肌腱再次断裂的发生率从未被调查过。
对梅奥诊所的医疗/外科索引进行了检索,并确定了 1981 年 1 月至 2009 年 5 月期间的所有肱二头肌远端肌腱修复术。所有完成 12 个月或更长时间随访的患者均被纳入。所有的图表都进行了审查,并在必要时联系患者以确定是否有再次断裂。我们还调查了导致再次断裂的情况。
我们共确定了 190 例肱二头肌远端肌腱断裂并接受修复,符合我们的纳入和排除标准。在这 190 例修复中,172 例(90.5%)采用了 Mayo 改良的 Boyd-Anderson 2 切口技术。13 例(7.3%)患者为双侧断裂。6 例(3.2%)初次断裂发生在女性,其中 4 例为部分断裂。女性部分断裂比完全断裂更为常见,差异有统计学意义(P=0.05)。我们发现了 3 例再次断裂(1.5%),均发生在指数手术 3 周内。
初次修复肱二头肌远端肌腱后再断裂率较低,为 1.5%,发生在指数修复后 3 周内。这似乎是由于患者的依从性和对修复物施加的过度力量所致。我们还发现,女性发生肱二头肌远端肌腱撕裂的发生率为 3.2%,其中部分撕裂比完全撕裂更为常见。
IV 级,病例系列,治疗研究。