Kose Ozkan, Kilicaslan Omer Faruk, Guler Ferhat, Acar Baver, Yuksel Halil Yalçın
Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Uncalı mahallesi Toroslar caddesi, Samut Comfort Palace E Blok No: 2, Konyaaltı, Antalya, Turkey.
Eur J Orthop Surg Traumatol. 2015 Oct;25(7):1131-9. doi: 10.1007/s00590-015-1669-3. Epub 2015 Jul 12.
The purpose of this study was to present the functional outcomes and complications after primary repair of triceps tendon ruptures (TTR).
A retrospective review was performed on eight patients (six males, two females) who underwent transosseous suture repair for TTR. Mayo elbow score, range of motion, muscle strength and patient satisfaction were evaluated after at least 1-year follow-up.
The mean age of the patients was 25.1 years (range 16-42). The mechanism of injury was a sports injury in three patients, simple fall (fall on outstretched hand) in four and motorcycle accident in one patient. Two patients had associated radial head fracture, and one had a radial head fracture and trochlear fracture, and one patient had a medial epicondyle fracture. In two patients the diagnosis was missed at the initial admission to ED (delay, 20 and 75 days). Only one patient, who was a bodybuilder, had a history of anabolic steroid use, and the rest had no underlying disease or a predisposing factor for TTR. One of the patients with radial head fracture (displaced three parts) underwent simultaneous fixation using two headless screws. Patients were followed up for a mean of 18.8 months (range 12-26). At the final follow-up, all patients were satisfied with the treatment and the Mayo elbow score was excellent in six patients and good in two patients. There was 5° extension loss in two patients. Triceps muscle strength was 5/5 in all patients. Ulnar nerve entrapment occurred in one patient, so ulnar nerve release and anterior transposition were performed 3 months after surgery. Posterior interosseous nerve palsy occurred in one patient who underwent simultaneous radial head fracture fixation, but eventually returned back to normal 3 months postoperatively. All patients returned to their previous level of activity and occupation.
Transosseous suture technique is a safe and effective treatment method for acute TTR with a low rate of complications and excellent functional outcomes.
Retrospective case series, Level IV.
本研究旨在介绍肱三头肌腱断裂(TTR)一期修复后的功能结果及并发症。
对8例接受经骨缝合修复TTR的患者(6例男性,2例女性)进行回顾性分析。在至少随访1年后评估梅奥肘关节评分、活动范围、肌肉力量及患者满意度。
患者平均年龄25.1岁(范围16 - 42岁)。损伤机制为:3例患者因运动损伤,4例因简单跌倒(伸手撑地跌倒),1例因摩托车事故。2例患者合并桡骨头骨折,1例合并桡骨头骨折和滑车骨折,1例合并内上髁骨折。2例患者在初次急诊入院时漏诊(延迟诊断20天和75天)。仅1例患者为健美运动员,有使用合成代谢类固醇的病史,其余患者无TTR的基础疾病或易感因素。1例桡骨头骨折(三部分移位)患者同时使用两枚无头螺钉进行固定。患者平均随访18.8个月(范围12 - 26个月)。末次随访时,所有患者对治疗均满意,6例患者梅奥肘关节评分为优,2例为良。2例患者有5°的伸直受限。所有患者肱三头肌肌力均为5/5。1例患者发生尺神经卡压,术后3个月行尺神经松解及前置术。1例同时行桡骨头骨折固定的患者发生骨间后神经麻痹,但术后3个月最终恢复正常。所有患者均恢复至伤前的活动和工作水平。
经骨缝合技术是治疗急性TTR的一种安全有效的方法,并发症发生率低,功能结果良好。
回顾性病例系列,IV级。