Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
St George's University Medical School, St. George's, West Indies, Grenada.
J Shoulder Elbow Surg. 2020 May;29(5):1002-1009. doi: 10.1016/j.jse.2019.12.006. Epub 2020 Mar 5.
Among an active aging population, distal biceps tendon ruptures are becoming increasingly common. Typically, they are the result of an acute heavy eccentric load being placed on an already contracted muscle, and surgery is the gold standard treatment for optimal clinical and functional outcomes. Although improved strength has been shown after operative repair, there is little evidence available regarding a timeframe for return to work-related activity. The purpose of this study was to conduct a systematic review of the literature to provide guidance for return to work after a distal biceps repair.
The authors searched online databases (EMBASE, MEDLINE) from inception until October 11, 2018, for literature pertaining to functional outcomes after distal biceps repair. Study inclusion and exclusion criteria were established a priori and applied in duplicate independently by 2 reviewers.
Of the 480 initial studies, 40 papers satisfied full text inclusion criteria (19 case control studies, 12 retrospective reviews, 9 prospective reviews). A total of 1270 patients with 1280 distal bicep ruptures were included in the study. The mean age of patients was 45.38 years, and 97% (n = 1067) of reported patients were male. The mean follow-up time was 30 months (range, 6-84 months). After distal biceps repair, 1128 (89%) of patients were able to fully return to work without any modification of duties. Time to return to work was reported in 17 of the included studies with a mean of 14.37 ± 0.52 weeks.
The average time to return to work after distal biceps repair in the literature was just beyond 14 weeks. Patients and employers may be given a range between 3 and 4 months, with variation dependent on job demands. Further studies are needed to establish whether the surgical approach or repair technique has any impact on time to return to work.
在积极老龄化的人群中，肱二头肌远端肌腱撕裂越来越常见。通常情况下，它们是由于已经收缩的肌肉受到急性重度离心负荷而导致的，手术是获得最佳临床和功能结果的金标准治疗方法。尽管手术修复后力量得到了改善，但关于恢复与工作相关活动的时间框架，几乎没有证据。本研究的目的是对文献进行系统回顾，为肱二头肌远端修复后的工作恢复提供指导。
作者从创建数据库开始至 2018 年 10 月 11 日，在在线数据库（EMBASE、MEDLINE）中搜索与肱二头肌远端修复后功能结果相关的文献。研究纳入和排除标准事先确定，并由 2 名审查员独立重复应用。
在最初的 480 项研究中，有 40 篇论文符合全文纳入标准（19 项病例对照研究，12 项回顾性研究，9 项前瞻性研究）。共纳入 1270 例 1280 例肱二头肌远端撕裂患者。患者的平均年龄为 45.38 岁，97%（n=1067）的报告患者为男性。平均随访时间为 30 个月（范围，6-84 个月）。肱二头肌远端修复后，1128 例（89%）患者无需任何工作任务调整即可完全恢复工作。17 项纳入研究报告了恢复工作的时间，平均为 14.37±0.52 周。
文献中肱二头肌远端修复后恢复工作的平均时间为 14 周多一点。患者和雇主可能会有 3 到 4 个月的时间范围，具体取决于工作要求。需要进一步的研究来确定手术方法或修复技术是否对恢复工作的时间有任何影响。
