Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA.
Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA.
J Shoulder Elbow Surg. 2017 Dec;26(12):2213-2219. doi: 10.1016/j.jse.2017.08.006. Epub 2017 Oct 9.
Distal triceps tendon ruptures are relatively rare. Few studies have investigated functional outcomes after repair. There is no consensus on fixation methods for this injury. The purpose of this study was to compare the functional outcomes and the reoperation rates after distal triceps tendon repairs using transosseous tunnels and suture anchors.
A multicenter, retrospective review of all primary triceps repairs done between 2006 and 2015 was performed. Patients were included if they had a minimum of 2 years of follow-up. Intraoperative data recorded included repair method and number of anchors used when applicable. Patients were contacted for functional assessment with the Mayo Elbow Performance Score (MEPS). Postoperative complications were also queried.
There were 56 cases of primary triceps repair identified in an all-male cohort. Average age at time of surgery was 52.7 years; 58.9% of patients had transosseous repair, and 41.1% had suture anchor repair. The average follow-up was 4.26 years. The average postoperative MEPS score for all patients was 94. There was no difference in MEPS outcomes based on construct type. Postoperative Disabilities of the Arm, Shoulder, and Hand scores had an overall average of 4.81. A statistically significant difference was found, with the transosseous group averaging 2.98 points lower than the suture anchor group. This difference was not found to be clinically relevant. Only 4 patients had rerupture of the triceps requiring revision.
Primary repair of distal triceps tendon ruptures yields good, durable patient outcomes with minimal rerupture regardless of repair construct.
远侧肱三头肌腱断裂相对少见。很少有研究调查修复后的功能结果。对于这种损伤，固定方法尚无共识。本研究的目的是比较经骨隧道和缝线锚钉修复远侧肱三头肌腱后功能结果和再次手术率。
对 2006 年至 2015 年间所有初次肱三头肌腱修复进行了多中心、回顾性研究。如果患者随访时间至少 2 年，则将其纳入研究。记录了术中数据，包括修复方法和适用时使用的锚钉数量。通过 Mayo 肘部功能评分（MEPS）联系患者进行功能评估。还询问了术后并发症。
在一项全男性队列中，确定了 56 例原发性肱三头肌腱修复。手术时的平均年龄为 52.7 岁；58.9%的患者采用经骨隧道修复，41.1%的患者采用缝线锚钉修复。平均随访时间为 4.26 年。所有患者的平均术后 MEPS 评分为 94。根据构建类型，MEPS 结果没有差异。术后手臂、肩部和手的残疾总体平均为 4.81。经骨隧道组的平均评分比缝线锚钉组低 2.98 分，存在统计学差异，但差异无临床意义。仅有 4 例患者肱三头肌腱再次断裂需要修复。
无论修复结构如何，原发性远侧肱三头肌腱断裂修复可获得良好、持久的患者结果，很少有再断裂。
