Vandenberghe Melanie, van Riet Roger
Department of Orthopedic Surgery, AZ Monica Hospital, Stevenslei 20, 2100, Deurne, Belgium.
Department of Orthopedic Surgery, University Hospital Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium.
Curr Rev Musculoskelet Med. 2016 Jun;9(2):215-23. doi: 10.1007/s12178-016-9330-2.
Distal biceps tendon ruptures are relatively rare. Patients are usually middle-aged men involved in heavy labor. Patients usually present with the history of a pop and a proximal migration of the biceps muscle belly. Clinical exam should be sufficient to diagnose a complete rupture. Several specific tests have been described. Ultrasound scanning or MRI can help confirm the diagnosis. Radiographs are not needed to diagnose distal biceps tendon rupture but may show typical findings. Imaging, more specifically the flexion-abduction-supination (FABS) view MRI, is particularly helpful in the case of a partial rupture or chronic rupture of the distal biceps tendon. Results of surgical reinsertion of the distal biceps have been shown to be superior to conservative treatment. Different techniques and approaches have been described with specific advantages and disadvantages. Primary repair of the tendon is preferred. If this is no longer possible in chronic tears, an augmentation can be done using tendon graft. Results of surgical treatment are good in the vast majority of patients. Reruptures are rare but minor complications are common. Major complications may include posterior interosseous nerve palsy or radioulnar synostosis, but the risk of these complications may be decreased by meticulous attention to detail during surgery.
肱二头肌远端肌腱断裂相对少见。患者通常为从事重体力劳动的中年男性。患者通常有撕裂感及肱二头肌肌腹近端移位的病史。临床检查足以诊断完全断裂。已有多种特定检查方法被描述。超声扫描或磁共振成像（MRI）有助于确诊。诊断肱二头肌远端肌腱断裂无需X线片，但X线片可能显示典型表现。影像学检查，尤其是屈肘 - 外展 - 旋后（FABS）位MRI，对肱二头肌远端肌腱部分断裂或慢性断裂的情况特别有帮助。肱二头肌远端手术再植入的结果已显示优于保守治疗。已描述了不同的技术和入路，各有其特定的优缺点。首选肌腱一期修复。如果在慢性撕裂中不再可行，则可使用肌腱移植进行加强。绝大多数患者手术治疗效果良好。再断裂少见，但轻微并发症常见。主要并发症可能包括骨间后神经麻痹或桡尺骨融合，但通过手术中对细节的精心关注，这些并发症的风险可能会降低。
