Department and Clinic of Traumatology and Hand Surgery, Medical University, Wrocław, Poland.
Department of Physiotherapy, The College of Physiotherapy in Wrocław, Wrocław, Poland.
Med Sci Monit. 2017 Oct 17;23:4961-4972. doi: 10.12659/msm.903723.
BACKGROUND To date, no consensus has been reached regarding the preferred fixation method to use in the repair of distal biceps brachii tendon rupture. The aim of this study was to clinically and functionally (Mayo Elbow Performance Index, MEPI) assess the upper limb after surgical anatomic reinsertion of the distal biceps brachii tendon with the use of suture anchor fixation method with regard to postoperative time and limb dominance, and to assess postoperative complications. MATERIAL AND METHODS The sample comprised 18 males (age 52.09±8.89 years) after surgical anatomical distal biceps brachii reinsertion using suture anchor fixation. A comprehensive clinical and functional evaluation and pain assessment were performed. RESULTS In terms of postoperative complications, an isolated case of surgical site sensory disturbances was noted. Circumferences (p-value 0.21-1.00) and ROM (p-value 0.07-1.00) were similar in the operated and nonoperated limbs. The isometric torque (IT) values of muscles flexing and supinating the forearm were comparable in both limbs (p-value 0.14-0.95), but in patients with the operated dominant limb, the mean IT value was not higher than the value obtained in the nonoperated nondominant one. The MEPI indicated good and excellent results (80.00±15.00-90.00±8.66 points), but a detailed individual analysis showed that reported scores were not in line with objectively measured features. CONCLUSIONS The results of the comprehensive retrospective evaluation justify the clinical use of suture anchors fixation method in the surgical anatomical reinsertion of a ruptured distal biceps brachii tendon. The assessment of a patient should always report both subjective and objective measures.
迄今为止，对于修复肱二头肌远端肌腱撕裂，哪种固定方法更优，尚未达成共识。本研究旨在通过使用缝线锚定固定方法对肱二头肌远端肌腱进行解剖复位，从临床和功能（Mayo 肘部功能指数，MEPI）方面评估术后时间和肢体优势对上肢的影响，并评估术后并发症。
该样本包括 18 名男性（年龄 52.09±8.89 岁），均接受了使用缝线锚定固定方法的肱二头肌远端肌腱解剖复位手术。对所有患者进行了全面的临床和功能评估及疼痛评估。
在术后并发症方面，仅出现 1 例手术部位感觉障碍的孤立病例。患侧和健侧的周径（p 值 0.21-1.00）和 ROM（p 值 0.07-1.00）相似。患侧和健侧的前臂屈肌和旋后肌等速扭矩（IT）值具有可比性（p 值 0.14-0.95），但在患侧优势上肢中，平均 IT 值并不高于非患侧非优势上肢的 IT 值。MEPI 显示出良好和优秀的结果（80.00±15.00-90.00±8.66 分），但详细的个体分析表明，报告的分数与客观测量的特征不一致。
综合回顾性评估的结果证明了缝线锚定固定方法在肱二头肌远端肌腱断裂的手术解剖复位中的临床应用价值。对患者的评估应始终报告主观和客观测量结果。
