Phelps Brian M, Fomunung Clyde, Singer William, George Andrew, Jack Robert A
Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA.
Texas A&M School of Medicine, Bryan, Texas, USA.
Orthop J Sports Med. 2024 Oct 22;12(10):23259671241275956. doi: 10.1177/23259671241275956. eCollection 2024 Oct.
Distal triceps rupture is a rare injury that is commonly surgically repaired to improve elbow strength and function. Most patients are active and have goals to return to specific activities and sports. There is no gold standard rehabilitation protocol for return to sport (RTS) after distal triceps repair.
To identify in the literature any criteria used for RTS after distal triceps repair.
Scoping review; Level of evidence, 4.
Under PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, level 1 to 4 studies that examined distal triceps repair and had a minimum follow-up duration of 12 months were deemed eligible for study inclusion. Exclusion criteria encompassed studies that employed nonoperative treatment, lacked specific RTS criteria, or involved revision cases. The selected studies underwent assessment regarding RTS outcomes, timelines, rates, and methodological quality.
Of the initial 378 unique studies, 6 studies (including 116 patients involved in 16 different sports) met the inclusion criteria. Four of the studies reported RTS rates, with a mean of 89.3%. The duration of time for returning to sport was reported in 2 studies and varied from 4 to 6 months. The parameters most emphasized in the rehabilitation protocols were progressive range of motion exercises, followed by early immobilization and progressive strengthening exercises. Supervised therapy was reported in only 2 (33%) studies. Although all studies included a rehabilitation protocol and 5 studies included a timeline for RTS, only 1 study provided subjective criteria, and no studies utilized specific objective measurement criteria. The overall study quality was fair.
This review demonstrated that the overall RTS rate after distal triceps repair was high (89.3%), with no consensus on RTS criteria. Most studies included initial immobilization followed by progressive range of motion and strengthening. Timing after surgery was used as a measure to RTS in the minority of studies and varied between 4 and 6 months. Further research is needed to develop functional and performance-based metrics to better standardize RTS criteria and rehabilitation protocols.
肱三头肌远端断裂是一种罕见的损伤，通常通过手术修复以提高肘部力量和功能。大多数患者较为活跃，目标是恢复特定活动和运动。肱三头肌远端修复术后恢复运动（RTS）尚无金标准康复方案。
在文献中确定肱三头肌远端修复术后RTS所使用的任何标准。
范围综述；证据等级，4级。
根据PRISMA（系统评价和Meta分析优先报告项目）指南，1至4级研究中，检查肱三头肌远端修复且随访时间至少为12个月的研究被视为符合纳入标准。排除标准包括采用非手术治疗、缺乏特定RTS标准或涉及翻修病例的研究。对所选研究进行RTS结果、时间线、发生率和方法学质量的评估。
在最初的378项独特研究中，6项研究（包括116名参与16项不同运动的患者）符合纳入标准。其中4项研究报告了RTS发生率，平均为89.3%。2项研究报告了恢复运动的时间，从4个月到6个月不等。康复方案中最强调的参数是渐进性活动度练习，其次是早期固定和渐进性强化练习。只有2项（33%）研究报告了有监督的治疗。虽然所有研究都包括康复方案，5项研究包括RTS的时间线，但只有1项研究提供了主观标准，没有研究使用特定的客观测量标准。总体研究质量一般。
本综述表明，肱三头肌远端修复术后的总体RTS发生率较高（89.3%），但RTS标准尚无共识。大多数研究包括初始固定，随后是渐进性活动度和强化练习。少数研究将术后时间用作RTS的衡量标准，时间在4至6个月之间。需要进一步研究以制定基于功能和表现的指标，以更好地规范RTS标准和康复方案。
