Sekáč Jaroslav, Šagát Peter, Bartík Peter, Kilián Miroslav, Tohănean Dragoş Ioan, Perez Jason, Vasilcova Veronika, Durdík Štefan
Faculty of Medicine, Comenius University, 81372 Bratislava, Slovakia.
GSD/Health and Physical Education Department, Sport Sciences and Diagnostic Research Group, Prince Sultan University, Riyadh 11586, Saudi Arabia.
J Clin Med. 2024 Dec 20;13(24):7792. doi: 10.3390/jcm13247792.
This retrospective study is the only one in the last 10 years from central Europe and provides a current picture of prevalence, new diagnostic modalities, new methods of surgical treatment, and also offers new insights into post-operative care. Triceps tendon rupture is the least reported among all the tendon injuries in the literature. In general, effective treatments for tendon injuries are lacking because the understanding of tendon biology lags behind that of the other components of the musculoskeletal system. Tendon tissue has a low number of cells and growth hormones and thus a lack of natural healing ability. Understanding the links between the mechanical and biological parameters involved in tendon development, homeostasis, and repair is a prerequisite for the identification of effective treatments for chronic and acute tendon injuries. The authors statistically evaluated the set of patients with this diagnosis in the largest University Hospital in Slovakia over the last 10 years. Between 2014 and 2023, 23 patients with distal triceps tendon ruptures (DTTR) were treated at University Hospital. In some years not a single patient with this diagnosis underwent surgery, reinforcing the idea that DTTR may be either rare or underdiagnosed. The incidence in our region is 0.46 cases per 100,000 inhabitants. The average age of patients was 57.7 years, with a male predominance of 90%. Less than half of the patients (43.5%) underwent surgical intervention, and the median time from injury to surgery was less than 10 days. This rapid timeline indicates a high standard of medical care, given the semi-elective nature of the surgery and the need for MRI (Magnetic Resonance Imaging) confirmation of tendon rupture exceeding 50% of the fibers before proceeding with surgery. The three standard surgical techniques were employed in approximately equal proportions. This study suggests that none of the methods is currently preferred, and that the choice of the technique was largely determined by perioperative findings and the surgeon's discretion. Post-operative complications were minimal, with only one patient experiencing any issues after surgery.
这项回顾性研究是过去10年中欧地区唯一的此类研究,它呈现了当前的患病率、新的诊断方式、新的手术治疗方法,还为术后护理提供了新的见解。在文献中,肱三头肌腱断裂是所有肌腱损伤中报道最少的。总体而言,由于对肌腱生物学的理解落后于肌肉骨骼系统的其他组成部分,目前缺乏有效的肌腱损伤治疗方法。肌腱组织细胞数量少且生长激素缺乏,因此缺乏自然愈合能力。了解肌腱发育、稳态和修复过程中涉及的机械和生物学参数之间的联系,是确定慢性和急性肌腱损伤有效治疗方法的先决条件。作者对斯洛伐克最大的大学医院过去10年中诊断为此病的患者群体进行了统计评估。2014年至2023年期间,大学医院共治疗了23例肱三头肌腱远端断裂(DTTR)患者。在某些年份,没有一例该诊断患者接受手术,这强化了DTTR可能罕见或诊断不足的观点。我们地区的发病率为每10万居民0.46例。患者的平均年龄为57.7岁,男性占比90%。不到一半的患者(43.5%)接受了手术干预,从受伤到手术的中位时间不到10天。考虑到手术的半选择性以及手术前需要MRI(磁共振成像)确认超过50%的纤维发生肌腱断裂,这一快速的时间线表明了高水平的医疗护理。三种标准手术技术的使用比例大致相同。这项研究表明,目前没有一种方法更受青睐,技术的选择很大程度上取决于围手术期的发现和外科医生的判断。术后并发症极少,只有一名患者术后出现了问题。