Lee Jung Hyun, Kim Kyung Chul, Lee Ji-Ho, Ahn Kee Baek, Rhyou In Hyeok
Department of Orthopaedic Surgery, Upper Extremity and Microsurgery Center, Pohang Semyeong Christianity Hospital, Pohang, Korea.
Clin Shoulder Elb. 2018 Dec 1;21(4):213-219. doi: 10.5397/cise.2018.21.4.213. eCollection 2018 Dec.
The study of conservative and surgical treatment of distal biceps tendinopathy and associated biceps tendon partial rupture.
Twenty-one cases with distal biceps tendonitis and partial ruptures were studied who visited Pohang Semyeong Christianity Hospital from June 2010 to August 2017. The mean age was 57.1 years (39-69 years), 14 males and 7 females. The mean duration of symptom at the time of first visit was 4.9 months (0.2-14 months). Ultrasonography and magnetic resonance imaging were performed for patients with severe symptoms. According to the severity of the symptoms, splint immobilization, oral nonsteroidal anti-inflammatory drugs, and ultrasound-guided steroid injection were performed. Surgical treatment was performed if the patient did not respond to conservative treatment for 3 to 6 months or longer.
There were 9 cases of partial rupture of the distal biceps tendon associated with distal biceps tendinopathy on imaging studies. Conservative treatment showed symptomatic improvement in 16 of 21 cases. In 4 cases with a relatively mild symptom, anti-inflammatory analgesics and intermittent splinting showed good result. In 12 cases, symptoms improved after ultrasonography-guided steroid injection. Surgical treatment was performed on 5 cases that did not respond to conservative treatment.
Conservative treatment of distal biceps tendinopathy may promise good results. However, in case of partial tear of the distal biceps tendon and refractory to conservative treatment, surgical treatment may be needed.
肱二头肌远端肌腱病及相关肱二头肌肌腱部分断裂的保守治疗与手术治疗研究。
研究了2010年6月至2017年8月期间就诊于浦项圣灵基督教医院的21例肱二头肌远端肌腱炎及部分断裂患者。平均年龄为57.1岁(39 - 69岁),男性14例,女性7例。首次就诊时症状的平均持续时间为4.9个月(0.2 - 14个月)。对症状严重的患者进行了超声检查和磁共振成像。根据症状的严重程度,进行了夹板固定、口服非甾体抗炎药以及超声引导下的类固醇注射。如果患者对保守治疗3至6个月或更长时间无反应,则进行手术治疗。
影像学研究显示,21例中有9例肱二头肌远端肌腱部分断裂与肱二头肌远端肌腱病相关。保守治疗使21例中的16例症状得到改善。在4例症状相对较轻的患者中,抗炎镇痛药和间歇性夹板固定效果良好。12例患者在超声引导下类固醇注射后症状改善。对5例对保守治疗无反应的患者进行了手术治疗。
肱二头肌远端肌腱病的保守治疗可能会取得良好效果。然而,如果肱二头肌远端肌腱出现部分撕裂且对保守治疗无效,则可能需要进行手术治疗。