Witkowski Jarosław, Kentel Maciej, Królikowska Aleksandra, Reichert Paweł
Department of Traumatology, Clinic of Traumatology and Hand Surgery, Wroclaw University Clinical Hospital, Wroclaw, Poland.
eMKaMED Medical Centre, Wroclaw, Poland.
Polim Med. 2016 Jul-Dec;46(2):163-169. doi: 10.17219/pim/0000.
Various surgical techniques for treating distal biceps brachii tendon injury have been described, and to date there is no consensus regarding the preferred fixation method for the anatomic reinsertion of the ruptured tendon.
The aim of the study was to clinically and functionally evaluate the upper limb after surgical anatomic reinsertion of the distal biceps brachii tendon using an ACL TightRope® RT with a titanium cortical button and ultra high molecular weight polyethylene (UHMWPE) suture, and to assess postoperative complications.
The sample comprised 3 patients. Clinical examination (history, measurements of the active range of forearm motion, arm circumference, the maximum isometric forearm supination and flexion muscle torque), pain evaluation (on a visual analogue scale [VAS]) and functional assessment (the Mayo Elbow Performance Index [MEPI] and Quick Disabilities of the Arm, Shoulder and Hand [DASH]) were carried out. Complications were documented.
The results of the range of motion measurements, arm circumferences and normalized isometric torque values of the muscle groups being studied were comparable in the involved and uninvolved limbs. The MEPI (x = 95.00 ± 10.42) and Quick DASH (x = 8.66 ± 18.04) scores revealed very good results. The VAS results were close to no pain (x = 3.33 ± 5.77 mm). No complications were noted.
The preliminary comprehensive clinical and functional assessment of the upper limb justify the clinical use of the ACL TightRope® RT with a titanium cortical button and UHMWPE suture in surgical anatomic reinsertion of the distal biceps brachii tendon. The early results with a small sample were encouraging, but studies with a larger number of cases and longer follow-up are needed.
已经描述了多种治疗肱二头肌远端肌腱损伤的手术技术，迄今为止，对于断裂肌腱的解剖再植入的首选固定方法尚无共识。
本研究的目的是对使用带有钛质皮质纽扣和超高分子量聚乙烯（UHMWPE）缝线的ACL TightRope® RT对肱二头肌远端肌腱进行手术解剖再植入后的上肢进行临床和功能评估，并评估术后并发症。
样本包括3例患者。进行了临床检查（病史、前臂活动范围测量、上臂围、最大等长前臂旋后和屈曲肌肉扭矩）、疼痛评估（视觉模拟量表[VAS]）和功能评估（梅奥肘关节功能指数[MEPI]和手臂、肩部和手部快速残疾评定量表[DASH]）。记录并发症情况。
所研究肌肉群的活动范围测量、上臂围和标准化等长扭矩值在患侧和未患侧肢体中具有可比性。MEPI（x = 95.00 ± 10.42）和快速DASH（x = 8.66 ± 18.04）评分显示结果非常好。VAS结果接近无痛（x = 3.33 ± 5.77 mm）。未观察到并发症。
对上肢进行的初步综合临床和功能评估证明，在肱二头肌远端肌腱的手术解剖再植入中，使用带有钛质皮质纽扣和UHMWPE缝线的ACL TightRope® RT具有临床应用价值。小样本的早期结果令人鼓舞，但需要更多病例和更长随访时间的研究。
