Abstract：
BACKGROUND: Distal biceps tendon repair is usually performed via a double-incision or single-incision bicortical drilling technique. However, these techniques are associated with specific complications and usually do not allow for anatomic footprint restoration. It was the aim of this study to report the clinical results of a double intracortical button anatomic footprint repair technique for distal biceps tendon tears. We hypothesized that this technique would result in supination strength comparable to the uninjured side with a low rerupture rate and minimal bony or neurologic complications.
METHODS: This was a retrospective, single-surgeon cohort study of a consecutive series of 22 patients with a mean (standard deviation) age of 50.7 (9.4) years and at least 1-year follow-up after distal biceps tendon repair. At final follow-up, complications, range of motion (ROM), the Patient-rated Elbow Evaluation (PREE), Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, visual analog scale (VAS) for pain, patient satisfaction, and supination strength in neutral as well as 60° of supination were analyzed. Radiographic evaluation was performed on a computed tomography scan.
RESULTS: One patient (4.5%) experienced slight paresthesia in the area of the lateral antebrachial cutaneous nerve. Heterotopic ossification was seen in 1 patient (4.5%). All patients recovered full ROM except for 1 who had 10° of loss of flexion and extension. Median PREE score was 4.6 (0-39.6), median MEP was 100 (70-100), and median DASH score was 1.4 (0-16.7). All but 1 patient were very satisfied with the outcome. The affected arm had a mean of 98% (±13%) of neutral supination strength (P = .633) and 94% (±12%) of supination strength in 60° (P = .054) compared with the contralateral, unaffected side. There were 4 cases (18.2%) of cortical thinning due to at least 1 button and 1 case of button pullout (4.5%).
CONCLUSIONS: The double intracortical button anatomic footprint repair technique seems to provide reliable restoration of supination strength and excellent patient satisfaction while minimizing complications, particularly nerve damage and heterotopic ossification.
METHODS: This was a retrospective, single-surgeon cohort study of a consecutive series of 22 patients with a mean (standard deviation) age of 50.7 (9.4) years and at least 1-year follow-up after distal biceps tendon repair. At final follow-up, complications, range of motion (ROM), the Patient-rated Elbow Evaluation (PREE), Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, visual analog scale (VAS) for pain, patient satisfaction, and supination strength in neutral as well as 60° of supination were analyzed. Radiographic evaluation was performed on a computed tomography scan.
RESULTS: One patient (4.5%) experienced slight paresthesia in the area of the lateral antebrachial cutaneous nerve. Heterotopic ossification was seen in 1 patient (4.5%). All patients recovered full ROM except for 1 who had 10° of loss of flexion and extension. Median PREE score was 4.6 (0-39.6), median MEP was 100 (70-100), and median DASH score was 1.4 (0-16.7). All but 1 patient were very satisfied with the outcome. The affected arm had a mean of 98% (±13%) of neutral supination strength (P = .633) and 94% (±12%) of supination strength in 60° (P = .054) compared with the contralateral, unaffected side. There were 4 cases (18.2%) of cortical thinning due to at least 1 button and 1 case of button pullout (4.5%).
CONCLUSIONS: The double intracortical button anatomic footprint repair technique seems to provide reliable restoration of supination strength and excellent patient satisfaction while minimizing complications, particularly nerve damage and heterotopic ossification.
摘要：
背景：肱二头肌远端肌腱修复通常通过双切口或单切口双皮质钻孔技术进行。然而,这些技术与特定的并发症相关,通常不允许解剖足迹恢复.这项研究的目的是报告双皮质内纽扣解剖足迹修复技术治疗远端二头肌肌腱撕裂的临床结果。我们假设该技术将导致与未受伤侧相当的旋后强度，再破裂率低，骨性或神经系统并发症最少。
方法：这是一个回顾性研究，单外科医生队列研究连续系列22例患者，平均（SD）年龄为50.7（9.4）岁，在肱二头肌远端肌腱修复后至少1年的随访。在最后的后续行动中，并发症,运动范围（ROM），患者额定弯头评估（PREE），梅奥肘部性能得分（MEPS），手臂的残疾，肩膀,和手(DASH)问卷，疼痛的视觉模拟量表（VAS），分析了患者在中立和60°旋后的满意度和旋后强度。在CT扫描上进行射线照相评估。
结果：一名患者（4.5%）在前臂外侧皮神经区域出现轻微感觉异常。在一名患者中观察到异位骨化（4.5％）。所有患者均恢复了完整的ROM，除了一个屈曲和伸展损失10°的患者。PREE中位数为4.6（0-39.6），MEP中位数为100(70~100),DASH中位数为1.4(0~16.7).除一名患者外，所有患者对结果都非常满意。与对侧相比，受影响的手臂在60°（p=0.054）时平均有98％（±13）的中性旋后强度（p=0.633）和94％（±12）的旋后强度，不受影响的一面。有4例(18.2%)由于至少一个按钮和1例按钮拉出(4.5%)而导致皮质变薄。
结论：双皮质内纽扣解剖足迹修复技术似乎提供了可靠的旋光强度恢复，出色的患者满意度，同时最大限度地减少并发症，特别是神经损伤和异位骨化。
方法：这是一个回顾性研究，单外科医生队列研究连续系列22例患者，平均（SD）年龄为50.7（9.4）岁，在肱二头肌远端肌腱修复后至少1年的随访。在最后的后续行动中，并发症,运动范围（ROM），患者额定弯头评估（PREE），梅奥肘部性能得分（MEPS），手臂的残疾，肩膀,和手(DASH)问卷，疼痛的视觉模拟量表（VAS），分析了患者在中立和60°旋后的满意度和旋后强度。在CT扫描上进行射线照相评估。
结果：一名患者（4.5%）在前臂外侧皮神经区域出现轻微感觉异常。在一名患者中观察到异位骨化（4.5％）。所有患者均恢复了完整的ROM，除了一个屈曲和伸展损失10°的患者。PREE中位数为4.6（0-39.6），MEP中位数为100(70~100),DASH中位数为1.4(0~16.7).除一名患者外，所有患者对结果都非常满意。与对侧相比，受影响的手臂在60°（p=0.054）时平均有98％（±13）的中性旋后强度（p=0.633）和94％（±12）的旋后强度，不受影响的一面。有4例(18.2%)由于至少一个按钮和1例按钮拉出(4.5%)而导致皮质变薄。
结论：双皮质内纽扣解剖足迹修复技术似乎提供了可靠的旋光强度恢复，出色的患者满意度，同时最大限度地减少并发症，特别是神经损伤和异位骨化。
