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肱三头肌远侧部修复的手术结果、趋势和风险因素。

Surgical Outcomes, Trends, and Risk Factors of Distal Triceps Repairs.

机构信息

University of Chicago, IL, USA.

Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.

出版信息

Hand (N Y). 2023 Nov;18(8):1300-1306. doi: 10.1177/15589447221095114. Epub 2022 Jun 6.

Abstract

BACKGROUND

Distal triceps ruptures are rare, and complete ruptures are commonly treated with surgery. Studies of patients in small cohorts with distal triceps tear have reported outcomes and risk factors; however, large-scale data are scant. This study seeks to determine current trends, outcomes, and risk factors of distal triceps tears.

METHODS

Within a large insurance claims database, distal triceps repair patients were identified through Current Procedural Terminology coding with concomitant distal triceps International Classification of Diseases, 9th Revision/10th Revision diagnosis codes and 1-year active status before and after surgery. Demographics, total costs, 90-day complications, and revision rates within 1 year of index surgery were analyzed. Logistic regression was performed for revision and complication rates using sex, age, and comorbidities (anabolic steroid use, diabetes, ischemic heart disease, tobacco use, rheumatoid arthritis, and chronic kidney disease).

RESULTS

A total of 8143 patients were included in the cohort. Male patients and patients aged 40 to 59 years comprised most of the study population. The postoperative complication rate was 5.8%, and the 1-year revision rate was 2.6%. Male sex, age >60 years, ischemic heart disease, rheumatoid arthritis, and chronic kidney disease were statistically significant risk factors for higher 90-day complication rates. Anabolic steroid use significantly increased the risk of surgical revision.

CONCLUSIONS

Distal triceps repairs in this large cohort study occur most frequently in men aged 40 to 59 years. Complications are generally low, with age >60 years, male sex, ischemic heart disease, rheumatoid arthritis, and chronic kidney disease as risk factors for 90-day complications and prior anabolic steroid use as a risk factor for 1-year revision surgery. This information can help to improve education and expectations of this procedure.

摘要

背景

远端肱三头肌撕裂较为罕见,且完全撕裂通常采用手术治疗。小队列中患有远端肱三头肌撕裂的患者的研究报告了结果和风险因素;然而,大规模数据却很少。本研究旨在确定远端肱三头肌撕裂的当前趋势、结果和风险因素。

方法

在一个大型保险索赔数据库中,通过当前程序术语编码,结合远端肱三头肌国际疾病分类,第 9 版/第 10 版诊断代码,并在手术前后 1 年保持活动状态,确定远端肱三头肌修复患者。分析了人口统计学资料、总费用、90 天并发症和索引手术后 1 年内的翻修率。使用性别、年龄和合并症(使用合成代谢类固醇、糖尿病、缺血性心脏病、吸烟、类风湿关节炎和慢性肾脏病)对翻修率和并发症率进行 logistic 回归。

结果

共有 8143 例患者纳入队列。男性患者和 40 至 59 岁的患者构成了研究人群的大部分。术后并发症发生率为 5.8%,1 年翻修率为 2.6%。男性、年龄>60 岁、缺血性心脏病、类风湿关节炎和慢性肾脏病是 90 天并发症发生率较高的统计学显著风险因素。使用合成代谢类固醇显著增加了手术翻修的风险。

结论

在这项大型队列研究中,最常见的远端肱三头肌修复发生在 40 至 59 岁的男性中。并发症一般较低,年龄>60 岁、男性、缺血性心脏病、类风湿关节炎和慢性肾脏病是 90 天并发症的危险因素,而既往使用合成代谢类固醇是 1 年翻修手术的危险因素。这些信息可以帮助提高对该手术的教育和期望。

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