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可调式皮质纽扣治疗胸大肌断裂的手术治疗

Surgical treatment of pectoralis major muscle rupture with adjustable cortical button.

作者信息

Pochini Alberto de Castro, Rodrigues Marcus de Souza Barbosa, Yamashita Larissa, Belangero Paulo Santoro, Andreoli Carlos Vicente, Ejnisman Benno

机构信息

Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

出版信息

Rev Bras Ortop. 2017 Dec 6;53(1):60-66. doi: 10.1016/j.rboe.2017.11.005. eCollection 2018 Jan-Feb.

Abstract

OBJECTIVE

To assess the tendon reconstruction technique for total rupture of the pectoralis major muscle using an adjustable cortical button.

METHODS

Prospective study of 27 male patients with a mean age of 29.9 (SD = 5.3 years) and follow-up of 2.3 years. The procedure consisted of autologous grafts taken from the semitendinosus and gracilis tendons and an adjustable cortical button. Patients were evaluated functionally by the Bak criteria.

RESULTS

The surgical treatment of pectoralis major muscle tendon reconstruction was performed in the early stages (three weeks) in six patients (22.2%) and in 21 patients (77.8%), in the late stages. Patients operated with the adjustable cortical button technique obtained 96.3% excellent or good results, with only 3.7% having poor results (Bak criteria). Of the total, 85.2% were injured while performing bench press exercises and 14.8%, during the practice of Brazilian jiu-jitsu or wrestling. All weight-lifting athletes had history of anabolic steroid use.

CONCLUSION

The early or delayed reconstruction of ruptured pectoralis major muscle tendons with considerable muscle retraction, using an adjustable cortical button and autologous knee flexor grafts, showed a high rate of good results.

摘要

目的

评估使用可调节皮质纽扣进行胸大肌完全断裂的肌腱重建技术。

方法

对27例男性患者进行前瞻性研究,平均年龄29.9岁(标准差=5.3岁),随访2.3年。该手术包括取自半腱肌和股薄肌腱的自体移植物以及一个可调节皮质纽扣。采用Bak标准对患者进行功能评估。

结果

6例患者(22.2%)在早期(三周)进行了胸大肌肌腱重建手术治疗,21例患者(77.8%)在晚期进行了手术。采用可调节皮质纽扣技术进行手术的患者获得了96.3%的优或良结果,只有3.7%的结果较差(Bak标准)。其中,85.2%的患者在进行卧推练习时受伤,14.8%的患者在巴西柔术或摔跤练习中受伤。所有举重运动员都有使用合成代谢类固醇的历史。

结论

使用可调节皮质纽扣和自体膝屈肌移植物对胸大肌肌腱断裂并伴有明显肌肉回缩的患者进行早期或延迟重建,显示出较高的良好结果率。

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