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使用双皮质纽扣在双切口入路中安全修复肱二头肌远端:一项尸体分析

Use of a Bicortical Button to Safely Repair the Distal Biceps in a Two-Incision Approach: A Cadaveric Analysis.

作者信息

Barlow Jonathan D, McNeilan Ryan J, Speeckaert Amy, Beals Corey T, Awan Hisham M

机构信息

Hand and Upper Extremity Center, Department of Orthopaedics, The Ohio State University Medical Center, Columbus, OH.

Hand and Upper Extremity Center, Department of Orthopaedics, The Ohio State University Medical Center, Columbus, OH.

出版信息

J Hand Surg Am. 2017 Jul;42(7):570.e1-570.e6. doi: 10.1016/j.jhsa.2017.03.025. Epub 2017 Apr 20.

DOI:10.1016/j.jhsa.2017.03.025
PMID:28434835
Abstract

PURPOSE

No consensus has been reached on the most effective anatomic approach or fixation method for distal biceps repair. It is our hypothesis that, using a cortical biceps button through a 2-incision technique, the distal biceps can be safely and anatomically repaired.

METHODS

A 2-incision biceps button distal biceps repair was completed on 10 fresh-frozen cadavers. The proximity of the guide pin to the critical structures of the forearm, including the posterior interosseous nerve and recurrent radial artery, was measured. The location of repair was mapped and compared with anatomic insertion.

RESULTS

The average distance from the tip of the guide pin to the posterior interosseous nerve was 11.4 mm (range, 8-14 mm). The average distance from the tip of the guide pin to the recurrent radial artery was 12.5 mm (range, 8-19 mm). The distal biceps tendon was repaired to the anatomic insertion site on the tuberosity using the biceps button technique in all specimens.

CONCLUSIONS

The 2-incision biceps button repair described here allows safe and accurate repair of the tendon to the radial tuberosity in this cadaveric study.

CLINICAL RELEVANCE

The goal of distal biceps repair is to safely, securely, and anatomically repair the torn biceps tendon to the radial tuberosity. The most commonly performed techniques (single anterior incision with cortical button and the double-incision procedure with bone tunnels and trough) have limitations. A 2-incision button repair safely and anatomically repairs the distal biceps tendon.

摘要

目的

对于肱二头肌远端修复的最有效解剖入路或固定方法尚未达成共识。我们的假设是,通过双切口技术使用皮质肱二头肌纽扣,肱二头肌远端能够安全且符合解剖结构地进行修复。

方法

对10具新鲜冷冻尸体进行了双切口肱二头肌纽扣肱二头肌远端修复。测量了导针与前臂关键结构(包括骨间后神经和桡返动脉)的距离。绘制修复位置并与解剖学止点进行比较。

结果

导针尖端至骨间后神经的平均距离为11.4毫米(范围8 - 14毫米)。导针尖端至桡返动脉的平均距离为12.5毫米(范围8 - 19毫米)。在所有标本中,均使用肱二头肌纽扣技术将肱二头肌远端肌腱修复至结节的解剖学止点部位。

结论

在本尸体研究中,此处描述的双切口肱二头肌纽扣修复可实现肌腱至桡骨结节的安全且精确的修复。

临床意义

肱二头肌远端修复的目标是将撕裂的肱二头肌肌腱安全、牢固且符合解剖结构地修复至桡骨结节。最常用的技术(单前切口加皮质纽扣以及双切口加骨隧道和骨槽)存在局限性。双切口纽扣修复可安全且符合解剖结构地修复肱二头肌远端肌腱。

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