Maciel Rafael Almeida, Costa Priscilla Silva, Figueiredo Eduardo Antônio, Belangero Paulo Santoro, Pochini Alberto de Castro, Ejnisman Benno
Universidade Federal de São Paulo, Departamento de Ortopedia e Traumatologia, Centro de Traumatologia do Esporte, São Paulo, SP, Brazil.
Rev Bras Ortop. 2017 Mar 9;52(2):148-153. doi: 10.1016/j.rboe.2017.03.004. eCollection 2017 Mar-Apr.
Clinical and functional assessment of the surgical treatment for acute injury of the distal insertion of the biceps brachial performed with a surgical technique using a single incision in proximal forearm and fixation with suture anchors in the radial tuberosity.
This study reviewed the medical records of patients who underwent surgical treatment of distal biceps injury during the period between January 2008 and July 2014. In a mean follow-up of 12 months, 22 patients with complete and acute injury, diagnosed through physical examination and imaging studies, were functionally assessed in the postoperative period regarding the range of motion (degrees of flexion-extension and pronation-supination), the presence of pain (VAS), the Andrews Carson-score, and the Mayo Elbow Performance Score (MEPS).
During the postoperative follow-up assessment, no patient reported pain by VAS scale; all were satisfied with the esthetic appearance of the surgery. The range of articular movement remained unchanged at 95.4% of patients, with the loss of 8° of supination in one patient. No changes in muscle strength were observed. The results of the Andrews-Carson score were good in 4.6% and excellent in 95.4% of cases; the MEPS presented 100% of excellent results. The rate of complications was 27.2%, similar to the literature.
Surgical repair of acute injury of the distal biceps trough a single incision in the proximal forearm and fixation with two suture anchors in the radial tuberosity is an effective and safe therapeutic option, allowing early motion and good functional results.
采用在前臂近端单一切口的手术技术及在桡骨粗隆用缝线锚钉固定的方法，对肱二头肌远端止点急性损伤的手术治疗进行临床和功能评估。
本研究回顾了2008年1月至2014年7月期间接受肱二头肌远端损伤手术治疗患者的病历。平均随访12个月，通过体格检查和影像学研究确诊的22例完全性急性损伤患者，在术后对其活动范围（屈伸和旋前-旋后度数）、疼痛情况（视觉模拟评分法）、安德鲁斯·卡森评分以及梅奥肘关节功能评分（MEPS）进行功能评估。
在术后随访评估中，无患者按视觉模拟评分法报告疼痛；所有患者对手术的美观效果均满意。95.4%的患者关节活动范围保持不变，1例患者旋后丧失8°。未观察到肌肉力量变化。安德鲁斯-卡森评分结果在4.6%的病例中为良好，95.4%为优秀；MEPS显示100%为优秀结果。并发症发生率为27.2%，与文献报道相似。
通过在前臂近端单一切口及在桡骨粗隆用两枚缝线锚钉固定来手术修复肱二头肌远端急性损伤是一种有效且安全的治疗选择，可实现早期活动并获得良好的功能结果。
