Overmann Archie L, Colantonio Donald F, Wheatley Benjamin M, Volk William R, Kilcoyne Kelly G, Dickens Jonathan F
Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Orthop J Sports Med. 2019 Mar 28;7(3):2325967119833420. doi: 10.1177/2325967119833420. eCollection 2019 Mar.
Biceps tenodesis is a procedure that can address biceps and labral pathology. While there is an increased risk of humeral fracture after biceps tenodesis, it has been described only in case reports.
To identify the incidence, demographics, and characteristics of humeral shaft fractures after biceps tenodesis.
Case series; Level of evidence, 4.
The US Military Health System Data Repository was searched for patients with a Current Procedural Terminology code for biceps tenodesis between January 2013 and December 2016. The cohort of identified patients was then searched for those assigned a code for humeral fracture per the International Classification of Diseases, 9th Revision and 10th Revision. The electronic health records and radiographs of patients who were diagnosed with a humeral fracture were then evaluated to confirm that the fracture was related to the biceps tenodesis. Records were then reviewed for patient demographics, radiographs, operative reports, and clinical notes.
A total of 15,085 biceps tenodeses were performed between January 2013 and December 2016. There were 11 postoperative and 1 intraoperative humeral fractures. The incidence of fracture was <0.1%. All fractures were extra-articular spiral fractures that propagated through the tenodesis site. Eight patients were treated with functional bracing, 3 with open reduction and internal fixation, and 1 with a soft tissue biceps tenodesis revision. Of 8 patients successfully treated nonoperatively, 6 regained full range of shoulder motion. Only 2 of the 4 patients who required operative treatment regained full range of shoulder motion.
Humeral shaft fracture after biceps tenodesis is a rare complication that occurs in 7.9 out of 10,000 cases. Fractures occurred after various methods of fixation, including suture anchor, cortical button, and interference screw. Most patients were initially treated nonoperatively, and those who healed usually achieved full range of motion; however, those who required operative intervention often had restricted range of motion on final follow-up. Future studies should determine risk factors for fracture after biceps tenodesis.
肱二头肌肌腱固定术是一种可解决肱二头肌和盂唇病变的手术。虽然肱二头肌肌腱固定术后肱骨骨折的风险增加，但仅在病例报告中有所描述。
确定肱二头肌肌腱固定术后肱骨干骨折的发生率、人口统计学特征和特点。
病例系列；证据等级，4级。
检索美国军事医疗系统数据储存库，查找2013年1月至2016年12月间有肱二头肌肌腱固定术现行手术操作术语编码的患者。然后在确定的患者队列中查找那些根据国际疾病分类第9版和第10版被分配肱骨骨折编码的患者。接着对诊断为肱骨骨折的患者的电子健康记录和X线片进行评估，以确认骨折与肱二头肌肌腱固定术有关。然后审查记录中的患者人口统计学特征、X线片、手术报告和临床记录。
2013年1月至2016年12月间共进行了15085例肱二头肌肌腱固定术。术后有11例肱骨骨折，术中1例。骨折发生率<0.1%。所有骨折均为经肌腱固定部位传播的关节外螺旋骨折。8例患者采用功能支具治疗，3例采用切开复位内固定，1例采用软组织肱二头肌肌腱固定术翻修。在8例非手术成功治疗的患者中，6例恢复了肩部的全范围活动。在4例需要手术治疗的患者中，只有2例恢复了肩部的全范围活动。
肱二头肌肌腱固定术后肱骨干骨折是一种罕见的并发症，每10000例中发生7.9例。骨折发生在各种固定方法之后，包括缝线锚钉、皮质纽扣和干涉螺钉。大多数患者最初采用非手术治疗，愈合的患者通常能达到全范围活动；然而，那些需要手术干预的患者在最终随访时活动范围往往受限。未来的研究应确定肱二头肌肌腱固定术后骨折的危险因素。
