Caekebeke Pieter, Corten Kristoff, Duerinckx Joris
Orthopaedic Department, Ziekenhuis Oost-Limburg, Genk, Belgium.
Orthopaedic Department, Ziekenhuis Oost-Limburg, Genk, Belgium.
J Shoulder Elbow Surg. 2016 Mar;25(3):349-54. doi: 10.1016/j.jse.2015.12.007.
Distal biceps tendon repair to the radial tuberosity can be conducted by means of an interference screw in combination with a transosseous button. Bioabsorbable interference screws have been associated with complications such as severe osteolytic reactions. We questioned whether patients with a distal biceps tendon repair with bioabsorbable poly-L-lactide (PLLA) screws had different functional, clinical, and radiologic outcome than patients with nonabsorbable poly-ether ether ketone (PEEK) screws.
Between 2010 and 2014, 23 patients with an acute distal biceps tendon rupture were treated with reinsertion of the distal biceps tendon in a bone tunnel at the radial tuberosity through a single anterior incision using a transosseous button combined with an interference screw. A PLLA screw was used in 12 patients and a PEEK screw in 11 patients. All patients were retrospectively evaluated with a minimal follow-up of 1 year clinically and by means of the visual analog scale for pain, Mayo Elbow Performance Score, and Disabilities of Arm, Shoulder and Hand Outcome Measure score. Bone tunnel volume was measured with computed tomography segmentation.
Elbow mobility and arm and forearm circumference were symmetric for all patients. The visual analog scale for pain was 0.2 in the PLLA group and 0.7 in the PEEK group. The Disabilities of Arm, Shoulder and Hand score and Mayo Elbow Performance Score were 5.4 and 98.7 in the PLLA group vs. 3.1 and 95.9 in the PEEK group. Bone tunnel enlargement of 43% in the PLLA and 38% in the PEEK group was noted.
Clinical and functional outcome at more than 1 year after distal biceps tendon repair was excellent in both groups. Bone tunnel widening occurred in all patients.
肱二头肌远端肌腱至桡骨粗隆的修复可通过干涉螺钉结合骨隧道纽扣来进行。生物可吸收干涉螺钉已出现诸如严重溶骨反应等并发症。我们质疑使用生物可吸收聚-L-丙交酯（PLLA）螺钉进行肱二头肌远端肌腱修复的患者与使用不可吸收聚醚醚酮（PEEK）螺钉的患者在功能、临床及影像学结果上是否存在差异。
2010年至2014年间，23例急性肱二头肌远端肌腱断裂患者通过单一前侧切口，采用骨隧道纽扣结合干涉螺钉的方式，将肱二头肌远端肌腱重新植入桡骨粗隆处的骨隧道。12例患者使用PLLA螺钉，11例患者使用PEEK螺钉。所有患者均进行回顾性评估，临床随访至少1年，并采用视觉模拟疼痛评分、梅奥肘关节功能评分以及上肢、肩部和手部功能障碍评定量表评分。通过计算机断层扫描分割测量骨隧道体积。
所有患者的肘关节活动度以及上臂和前臂周长均对称。PLLA组的视觉模拟疼痛评分为0.2，PEEK组为0.7。PLLA组的上肢、肩部和手部功能障碍评定量表评分及梅奥肘关节功能评分为5.4和98.7，而PEEK组分别为3.1和95.9。PLLA组骨隧道扩大43%，PEEK组为38%。
两组患者在肱二头肌远端肌腱修复术后1年以上的临床和功能结果均良好。所有患者均出现骨隧道增宽。
