Tagliero Adam J, Till Sara E, Pan Xuankang, Reinholz Anna K, Johnson Adam C, Sanchez-Sotelo Joaquin, Barlow Jonathan D, Camp Christopher L
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Department of Musculoskeletal Radiology, Mayo Clinic, Rochester Minnesota, USA.
Orthop J Sports Med. 2024 Oct 14;12(10):23259671241283787. doi: 10.1177/23259671241283787. eCollection 2024 Oct.
Surgical repair of full thickness biceps tears has demonstrated adequate outcomes in short and mid-term studies. However, data on the long-term outcomes of full thickness distal biceps injuries and their treatment are currently lacking.
PURPOSE/HYPOTHESIS: The purpose of this study was to report on patient demographics, injury characteristics, and long-term outcomes for patients with full-thickness distal biceps tears. It was hypothesized that complete distal biceps tears managed operatively would demonstrate robust clinical success at long-term follow-up.
Case series; Level of evidence, 4.
Patients with magnetic resonance imaging-confirmed, complete distal biceps tendon rupture sustained between 1996 and 2016 were identified. Patients were cross-referenced with a regional geographic database.
A total of 66 patients (3 female, 63 male) with a median age of 50.8 years (IQR, 41.5-60.4) and a median clinical follow-up of 14.7 years (IQR, 9.6-17.9 years) were included. Patients who sustained a full-thickness distal biceps tendon tear were likely to be in their early 50s, male, right-hand dominant, current/former smokers, and laborers with a history of traumatic injury during an intentional movement. Most of these patients had pain and supination weakness but no loss of range of motion. All included tears were treated operatively. At final follow-up, patients maintained a majority of near-normal range of motion (median total arc of flexion/extension 140° and supination/pronation 80°), excellent elbow flexion strength (91% of patients had full strength), and adequate elbow supination strength (76% of patients had full strength). The overall complication rate was 24%, with 16 out of 66 patients experiencing some type of complication between infection, rerupture, heterotopic ossification, reoperation, and nerve complications. Overall return to work was 98%, and 85% of those who returned to work did so without restrictions.
Complete tears of the distal biceps were most common in patients 50 years of age, male sex, right-hand dominant, and current/former smokers. The most common profession was laborer, and injuries were primarily traumatic in nature during intentional activity. Patients managed operatively demonstrated high rates of success at long-term follow-up with respect to elbow function and clinical outcomes.
在短期和中期研究中，肱二头肌全层撕裂的手术修复已显示出良好的效果。然而，目前缺乏关于肱二头肌远端全层损伤及其治疗的长期结果的数据。
目的/假设：本研究的目的是报告肱二头肌远端全层撕裂患者的人口统计学特征、损伤特点和长期结果。假设手术治疗的肱二头肌远端完全撕裂在长期随访中会显示出强大的临床成功率。
病例系列；证据等级，4级。
确定1996年至2016年间磁共振成像确诊的肱二头肌远端肌腱完全断裂的患者。患者与区域地理数据库进行交叉对照。
共纳入66例患者（3例女性，63例男性），中位年龄50.8岁（四分位间距，41.5 - 60.4岁），中位临床随访时间14.7年（四分位间距，9.6 - 17.9年）。肱二头肌远端肌腱全层撕裂的患者多为50岁出头的男性，右利手，当前/既往吸烟者，且为有故意运动时创伤史的劳动者。这些患者大多有疼痛和旋后无力，但活动范围无丧失。所有纳入的撕裂均接受了手术治疗。在末次随访时，患者保持了大部分接近正常的活动范围（屈曲/伸展总弧度中位数为140°，旋后/旋前为80°），肘关节屈曲力量优秀（91%的患者力量完全恢复），肘关节旋后力量足够（76%的患者力量完全恢复）。总体并发症发生率为24%，66例患者中有16例在感染、再断裂、异位骨化、再次手术和神经并发症之间出现了某种类型的并发症。总体重返工作率为98%，85%重返工作的患者无工作限制。
肱二头肌远端完全撕裂在50岁、男性、右利手、当前/既往吸烟者中最为常见。最常见的职业是劳动者，损伤主要是在故意活动期间的创伤性损伤。手术治疗的患者在长期随访中肘关节功能和临床结果方面显示出高成功率。
