Brush Parker L, Trenchfield Delano, Pohl Nicholas B, Swan Taylor L, Santana Adrian, Jones Christopher M, Namdari Surena, Beredjiklian Pedro K, Fletcher Daniel
Department of Orthopaedic Surgery, Philadelphia, PA, USA.
Department of Biomedical Engineering, University of South Carolina, Columbia, SC, USA.
JSES Rev Rep Tech. 2024 Jul 20;4(4):790-796. doi: 10.1016/j.xrrt.2024.06.008. eCollection 2024 Nov.
Distal triceps tendon ruptures are an uncommon injury with several reported repair techniques. Outcomes research between the repair techniques is complicated by the rarity of the injury as most published materials are based on small sample sizes and specific surgical techniques. This study compared surgical complications, reoperations, and range of motion between all suture transosseous tunnel only (TT), suture anchor only (SA), and transosseous tunnel plus suture anchor (TTSA) repair techniques.
We retrospectively identified patients who underwent a distal triceps repair at our tertiary-care institution from 2011 to 2021. The electronic medical record was reviewed for patient demographics, triceps rupture characteristics, repair technique, and postoperative complications.
This study includes 199 patients who underwent a repair by TT (82), SA (69), or TTSA (48) techniques. No differences were identified between groups with regards to demographics and medical comorbidities. Patients treated by SA technique were more likely to have a loss of elbow extension (SA: 14 [26.4%], TT: 6 [8.57%], TTSA: 4 [10.0%], = .014) postoperatively with an average loss of 9° for the patients in all groups. However, no differences were identified between the groups with regards to postoperative complications (TT: 15.9%, SA: 17.4%, TTSA: 18.8%, = .911), including triceps rerupture (TT: 6.10%, SA: 4.35%, TTSA: 12.5%, = .260), and reoperation (TT: 11.0%, SA: 11.6%, TTSA: 14.6%, = .822) rates.
Regardless of repair technique, distal triceps tendon repair surgery has a relatively high complication and reoperation rate. However, given the similarities between the various methods of repair, surgeons can be confident in repairing this type of injury by whichever modality they deem appropriate.
肱三头肌远端肌腱断裂是一种罕见的损伤,有多种报道的修复技术。由于该损伤罕见,大多数已发表的资料基于小样本量和特定手术技术,因此修复技术之间的疗效研究较为复杂。本研究比较了单纯经骨隧道缝合(TT)、单纯缝线锚钉(SA)和经骨隧道加缝线锚钉(TTSA)修复技术在手术并发症、再次手术情况及活动度方面的差异。
我们回顾性纳入了2011年至2021年在我们三级医疗机构接受肱三头肌远端修复的患者。查阅电子病历以获取患者人口统计学信息、肱三头肌断裂特征、修复技术及术后并发症情况。
本研究纳入了199例接受TT(82例)、SA(69例)或TTSA(48例)技术修复的患者。各组在人口统计学和内科合并症方面未发现差异。采用SA技术治疗的患者术后更易出现肘关节伸展功能丧失(SA组:14例[26.4%],TT组:6例[8.57%],TTSA组:4例[10.0%];P = 0.014),所有组患者平均丧失9°。然而,各组在术后并发症(TT组:15.9%,SA组:17.4%,TTSA组:18.8%;P = 0.911)方面未发现差异,包括肱三头肌再次断裂(TT组:6.10%,SA组:4.35%,TTSA组:12.5%;P = 0.260)及再次手术率(TT组:11.0%,SA组:11.6%,TTSA组:14.6%;P = 0.822)。
无论采用何种修复技术,肱三头肌远端肌腱修复手术都有相对较高的并发症和再次手术率。然而,鉴于各种修复方法之间的相似性,外科医生可以对采用他们认为合适的任何方式修复此类损伤充满信心。