Storti Thiago Medeiros, Dias Rafael Gomes, Dantas Gabriel Cesar Dias, Faria Rafael Salomon Silva, Simionatto João Eduardo, Paniago Alexandre Firmino
Instituto de Pesquisa e Ensino, Hospital Ortopédico e Medicina Especializada, Brasília, DF, Brasil.
Instituto do Ombro de Brasília, Brasília, DF, Brasil.
Rev Bras Ortop (Sao Paulo). 2021 Aug 13;56(5):656-663. doi: 10.1055/s-0041-1729566. eCollection 2021 Oct.
Clinical and functional evaluation of the surgical treatment for chronic injury of the distal biceps brachii applying a surgical technique with grafting of the distal triceps brachii tendon. A study based on a review of the medical records and clinical evaluation of the patients submitted to surgical treatment for chronic injury to the distal insertion of the biceps brachii between February 2015 and February 2017. In a 12-month-minimum postoperative follow-up, 7 patients were evaluated regarding the range of motion of the operated and non-operated elbows, flexion, upper-limb extension and supination with a digital dynamometer, the hook test, the satisfaction index, and the Disabilities of the Arm, Shoulder and Hand (DASH) and Mayo Elbow Performance Score (MEPS) intruments. During the postoperative functional evaluation, no patient reported dissatisfaction with the esthetic outcome of the incisions, and all of them were satisfied/very satisfied with the range of motion and strength of the operated limb. No neurovascular complications, surgical site infection or tendon rupture were observed. On the MEPS and DASH scales, all patients scored 100 and 0 respectively. The mean flexion was of 133.5° on the operated side, versus 139.2° on the non-operated side. The mean extension was of 5° on the operated side versus 0° on the non-operated side. The supination was of 86.5° versus 90°, and the pronation, 80° versus 80°, when comparing the operated and non-operated sides respectively. The mean flexion, extension and supination corresponded respectively to 92.5%, 96.4% and 86.8% of those of the non-operated limb. Recosntruction of the distal biceps brachii with triceps grafting seems to be an effective and safe option for the treatment of chronic distal biceps injuries.
应用肱三头肌远端肌腱移植手术技术治疗肱二头肌远端慢性损伤的临床及功能评估。 一项基于对2015年2月至2017年2月间因肱二头肌远端慢性损伤接受手术治疗患者的病历回顾及临床评估的研究。在至少12个月的术后随访中,对7例患者进行了评估,内容包括手术侧和非手术侧肘关节的活动范围、屈曲、上肢伸展和旋后情况,使用数字测力计、钩状试验、满意度指数以及上肢、肩部和手部功能障碍(DASH)和梅奥肘关节功能评分(MEPS)工具。 在术后功能评估中,没有患者对切口的美观效果表示不满,所有患者对手术肢体的活动范围和力量都感到满意/非常满意。未观察到神经血管并发症、手术部位感染或肌腱断裂。在MEPS和DASH量表上,所有患者的得分分别为100和0。手术侧平均屈曲角度为133.5°,非手术侧为139.2°。手术侧平均伸展角度为5°,非手术侧为0°。比较手术侧和非手术侧时,旋后角度分别为86.5°和90°,旋前角度均为80°。手术侧的平均屈曲、伸展和旋后角度分别相当于非手术肢体的92.5%、96.4%和86.8%。 用三头肌移植重建肱二头肌远端似乎是治疗肱二头肌远端慢性损伤的一种有效且安全的选择。