Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN.
Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN.
J Hand Surg Am. 2024 Sep;49(9):930.e1-930.e8. doi: 10.1016/j.jhsa.2022.11.015. Epub 2023 Jan 4.
The purpose of this study was to describe the outcomes of patients treated with surgical repair of partial tears of the distal biceps tendon.
The study was a retrospective review of repairs of partial tears of the distal biceps tendon performed by multiple surgeons from January 1, 2015 to October 15, 2020. Inclusion criteria consisted of preoperative magnetic resonance imaging indicative of distal biceps pathology without a complete tear and surgical treatment with intraoperative confirmation of a partial tear. The presence of preceding trauma, duration of symptoms, and postoperative complications were documented. Patients were contacted for outcome assessment using the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and Patient-Reported Elbow Evaluation outcome measures. Clinical outcomes were obtained from 56 of 74 (76%) eligible patients with an average follow-up of 46 months (range: 15-85 months).
After surgery, the median QuickDASH was 2.3 (interquartile range, 0-9.7), and the median Patient-Reported Elbow Evaluation score was 1 (interquartile range, 0-12). Postoperative QuickDASH scores were significantly lower than the preoperative scores. Known traumas preceding the symptoms and duration of symptoms before surgery were not significantly associated with the outcome. Of all eligible patients, 30 complications were reported in 25 (34%) patients and included 2 reruptures, 2 cases of heterotopic ossification, 1 deep infection, 1 case of implant irritation, 21 neuropraxias, and 3 hematomas. Five (7%) patients underwent 6 reoperations including 1 revision for a rerupture, 1 irrigation and debridement, 2 heterotopic ossification excisions, 1 hematoma evacuation, and 1 implant removal.
The results suggest that the repair of partial distal biceps tendon tears is a viable treatment option with significant improvement in QuickDASH. There was no significant relationship between the postoperative outcome and duration of symptoms or known traumas preceding the symptoms.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
本研究旨在描述接受手术修复部分撕裂的远端肱二头肌肌腱的患者的治疗结果。
本研究为回顾性研究,纳入了 2015 年 1 月 1 日至 2020 年 10 月 15 日期间由多位外科医生施行的手术修复部分撕裂的远端肱二头肌肌腱的患者。纳入标准为术前磁共振成像显示存在远端肱二头肌病变但未完全撕裂,且术中证实存在部分撕裂。记录术前创伤、症状持续时间和术后并发症。通过使用快速上肢功能问卷(QuickDASH)和患者报告的肘部评估结果来联系患者进行结果评估。56 例(76%)符合条件的患者获得了临床结果,平均随访时间为 46 个月(范围:15-85 个月)。
手术后,QuickDASH 的中位数为 2.3(四分位距,0-9.7),患者报告的肘部评估得分中位数为 1(四分位距,0-12)。术后 QuickDASH 评分明显低于术前评分。术前症状存在已知创伤和术前症状持续时间与结果无显著相关性。在所有符合条件的患者中,25 例(34%)患者报告了 30 例并发症,包括 2 例再撕裂、2 例异位骨化、1 例深部感染、1 例植入物刺激、21 例神经病变和 3 例血肿。5 例(7%)患者进行了 6 次翻修手术,包括 1 例再撕裂修复、1 例冲洗和清创术、2 例异位骨化切除术、1 例血肿清除术和 1 例植入物取出术。
研究结果表明,修复部分撕裂的远端肱二头肌肌腱是一种可行的治疗选择,可显著改善 QuickDASH 评分。术后结果与症状持续时间或术前已知创伤之间无显著关系。
类型的研究/证据水平:治疗性 IV 级。