Ribas Luiz Henrique Boraschi Vieira, Schor Breno, Filho Geraldo da Rocha Motta, Belangero Paulo Santoro
Aluno do Programa de Pós-Graduação do Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil.
Médico ortopedista, especialista em Ombro e Cotovelo, Instituto Vita, São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2023 Oct 30;58(5):e689-e697. doi: 10.1055/s-0043-1771488. eCollection 2023 Oct.
Acute distal biceps injuries clinically present with sudden pain and acute loss of flexion and supination strength. The main injury mechanism occurs during the eccentric load of the biceps. The hook test is the most significant examination test, presenting the highest sensibility and specificity for this lesion. Magnetic resonance imaging, the gold standard imaging test, can provide information regarding integrity and identify partial and/or complete tears. The surgical treatment uses an anterior or double approach and several reattachment techniques. Although there is no clinical evidence to recommend one fixation method over the other, biomechanical studies show that the cortical button resists better to failure. Although surgical treatment led to an 89% rate of return to work in 14 weeks, the recovery of high sports performance occurred in 1 year, with unsustainable outcomes.
急性肱二头肌远端损伤临床上表现为突发疼痛以及屈曲和旋后力量的急性丧失。主要损伤机制发生在肱二头肌的离心负荷过程中。钩试验是最重要的检查测试，对该损伤具有最高的敏感性和特异性。磁共振成像作为金标准成像检查，可提供有关完整性的信息并识别部分和/或完全撕裂。手术治疗采用前路或双入路以及多种重新附着技术。尽管尚无临床证据推荐一种固定方法优于另一种，但生物力学研究表明皮质纽扣对失效的抵抗力更强。虽然手术治疗使14周内的工作恢复率达到89%，但高水平运动表现的恢复需要1年时间，且结果并不理想。
