Service d'orthopédie, traumatologie, CHRU Pontchaillou, 35000 Rennes, France.
Service d'orthopédie traumatologie, faculté de médecine de Tours, université François Rabelais de Tours, CHRU Trousseau, 37170 Chambray-les-Tours, France.
Orthop Traumatol Surg Res. 2018 Oct;104(6):817-822. doi: 10.1016/j.otsr.2018.02.016. Epub 2018 May 24.
There is currently no consensus on the choice between tenotomy and tenodesis of the long head of the biceps tendon in rotator cuff repair. The Popeye sign is often seen as a drawback of tenotomy. The main objective of the present study was to determine the frequency and clinical impact of the Popeye sign.
The Popeye sign is rarely found clinically, and shows little functional impact following tenotomy.
A single-center non-randomized prospective study was conducted between February and October 2015 in all patients undergoing rotator cuff surgery. Patients without surgery on the long head of the biceps tendon were excluded. The rate of Popeye sign was assessed 6 months postoperatively. Tenotomy patients with and without Popeye sign were compared in terms of pain on visual analog scale≤3, gain in range of motion, improvement in subjective shoulder value, discomfort or cramps and gain in Constant score.
Seven of the 55 patients included (15.2%) showed postoperative Popeye sign. There were no differences between the groups with and without Popeye sign on any of the assessment criteria except for a significantly greater improvement in mean Constant range of motion score in the Popeye group: gain of 13.8 versus 3.8 points; p=0.01.
The Popeye sign was relatively rarely observed. Functional impact in the present study was slight. Longhead of the biceps tenotomy is a justifiable treatment option in case of associated rotator cuff tear repair.
IV, prospective non-randomized.
目前在肩袖修复中，对于肱二头肌长头肌腱的切断术与肌腱固定术的选择尚未达成共识。“大力水手征”常被视为切断术的一个缺点。本研究的主要目的是确定“大力水手征”的发生率及其临床影响。
临床上很少发现“大力水手征”，而且切断术后该征象的功能影响较小。
这是一项 2015 年 2 月至 10 月在所有接受肩袖手术的患者中进行的单中心非随机前瞻性研究。排除了肱二头肌长头肌腱未手术的患者。术后 6 个月评估“大力水手征”的发生率。比较存在和不存在“大力水手征”的切断术患者的视觉模拟评分（VAS）≤3 的疼痛率、运动范围的增加、主观肩部值的改善、不适或痉挛以及 Constant 评分的增加。
55 例患者中有 7 例（15.2%）出现术后“大力水手征”。除“大力水手征”组的平均 Constant 运动范围评分的改善明显更大（增加 13.8 分与 3.8 分；p=0.01）外，两组在任何评估标准上均无差异。
“大力水手征”相对少见。本研究中功能影响较小。在伴有肩袖撕裂修复的情况下，长头肌腱切断术是一种合理的治疗选择。
IV，前瞻性非随机。
