Simmer Filho Jair, Lara Paulo Henrique Schmidt, Leite Júnior Juarez, Belangero Paulo Santoro, Ejnisman Benno
Departamento de Ortopedia e Traumatologia, Hospital Estadual de Urgência e Emergência, Vitória, ES, Brasil.
Centro de Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2021 Aug;56(4):497-503. doi: 10.1055/s-0040-1714231. Epub 2020 Sep 25.
The objective of the present study was to determine whether there is fatty infiltration (FI) of the biceps brachii muscle mass after tenotomy or tenodesis for the treatment of tendon injuries in the long head of the biceps and to establish a relationship between FI with changes in the length of muscle fibers. Clinical and imaging analysis of 2 groups of patients (biceps tenodesis [16 patients] and biceps tenotomy [15 patients]). In both groups, we compared the findings on the contralateral side of each patient (control group). All patients had undergone unilateral biceps tenodesis or tenotomy, with postoperative follow-up of > 1 year. Magnetic resonance imaging (MRI) was performed on both arms of each patient following a specific protocol. Strength of elbow flexion was measured with a manual dynamometer, and the results were subjected to statistical analysis. The mean postoperative period before the MRI was 5 years, and no case of FI was observed in the anterior compartment of either arm of the evaluated patients. Seven patients had moderate or severe deformity in the operated arm. We found no significant relationship between arm deformity ( = 0.077), flexion strength percentage ( = 0.07) or pain on palpation of the bicipital groove ( = 0.103). None of the evaluated patients had evidence of FI in the muscle mass of the anterior arm compartment after the procedures. It was not possible to establish a correlation between the discrepancy of the biceps muscle length measured by MRI and the presence of FI in the anterior compartment of the arm.
本研究的目的是确定在肱二头肌长头肌腱损伤的治疗中，进行肌腱切断术或肌腱固定术后肱二头肌肌块是否存在脂肪浸润（FI），并建立FI与肌纤维长度变化之间的关系。 对两组患者（肱二头肌肌腱固定术[16例患者]和肱二头肌肌腱切断术[15例患者]）进行临床和影像学分析。在两组中，我们比较了每位患者对侧（对照组）的检查结果。所有患者均接受了单侧肱二头肌肌腱固定术或肌腱切断术，术后随访时间超过1年。按照特定方案对每位患者的双臂进行磁共振成像（MRI）检查。用手动测力计测量肘关节屈曲力量，并对结果进行统计分析。 MRI检查前的平均术后时间为5年，在评估患者的任何一侧手臂的前侧肌间隔均未观察到FI病例。7例患者手术侧手臂有中度或重度畸形。我们发现手臂畸形（P = 0.077）、屈曲力量百分比（P = 0.07）或肱二头肌沟触诊疼痛（P = 0.103）之间均无显著关系。 所有评估患者在手术后，其前臂肌间隔的肌块均无FI迹象。无法在MRI测量的肱二头肌长度差异与手臂前侧肌间隔FI的存在之间建立相关性。
