Ward James P, Shreve Mark C, Youm Thomas, Strauss Eric J
Bull Hosp Jt Dis (2013). 2014;72(1):110-9.
Distal biceps ruptures occur most commonly in middle-aged males and result from eccentric contraction of the biceps tendon. The injury typically presents with pain and a tearing sensation in the antecubital fossa with resultant weakness in flexion and supination strength. Physical exam maneuvers and diagnostic imaging aid in determining the diagnosis. Nonoperative management is reserved for elderly, low demand patients, while operative intervention is generally pursued for younger patients and can consist of nonanatomic repair to the brachialis or anatomic repair to the radial tuberosity. Anatomic repair through a one-incision or two-incision approach is commonplace, while the nonanatomic repairs are rarely performed. No clear advantage exists in operative management with a one-incision versus two-incision techniques. Chronic ruptures present a more difficult situation, and allograft augmentation is often necessary. Common complications after repair include transient nerve palsy, which often resolves, and heterotopic ossification. Despite these possible complications, most studies suggest that better patient outcomes are obtained with operative, anatomic reattachment of the distal biceps tendon.
肱二头肌远端断裂最常见于中年男性，由肱二头肌肌腱的离心收缩所致。损伤通常表现为肘前窝疼痛和撕裂感，导致屈曲和旋后力量减弱。体格检查手法和诊断性影像学检查有助于确诊。非手术治疗适用于老年、需求较低的患者，而手术干预一般适用于年轻患者，可包括对肱肌的非解剖修复或对桡骨粗隆的解剖修复。通过单切口或双切口入路进行解剖修复很常见，而非解剖修复很少进行。单切口与双切口技术在手术治疗中没有明显优势。慢性断裂情况更为棘手，通常需要同种异体移植增强。修复后的常见并发症包括常可自行缓解的短暂性神经麻痹和异位骨化。尽管有这些可能的并发症，但大多数研究表明，对肱二头肌远端肌腱进行手术解剖重新附着可获得更好的患者预后。
