■本研究的目的是对现有文献进行系统评价,评估慢性肱二头肌远端肌腱断裂后的手术结果。外科技术,包括初级修复,自体移植重建,和同种异体移植重建,进行了比较,以及主观和客观的临床结果和并发症发生率。
■通过PubMed对I-IV级研究进行了系统的文献检索,这些研究报告了经手术治疗的慢性肱二头肌远端肌腱断裂的结果,Cochrane协作,科学直接,和谷歌学者数据库。审查中确定了22篇论文,236名患者。确定每篇文章的改良Coleman方法学评分(CMS)以评估研究质量。患者报告的结果,术后活动范围,屈曲和旋起力量,记录术后并发症。MAYO肘部评分(MEPS)的报告比其他结果工具更一致。
■在我们的搜索中没有发现I级或II级研究,结果测量的异质性排除了荟萃分析。研究表明,无论采用何种手术技术,平均MEPS评分均在86至100之间。所有研究报告的平均屈伸弧等于或大于5-130°。报告的平均术后屈曲强度在未受影响的对侧的10%以内。直接修复和重建组最常见的并发症是前臂外侧皮神经感觉异常[直接修复:18-16.8%;重建:8-6.2%(同种异体移植:4-6%;自体移植:4-7%)]。Roperture并不常见,发生在三名接受直接修复的患者和一名自体移植重建后的患者中。
■慢性肱二头肌远端损伤的手术治疗产生良好的客观和主观结果。目前,现有证据表明直接修复,自体移植重建,或同种异体移植重建都是可行的治疗选择,结果相似.
UNASSIGNED: The purpose of this study was to perform a systematic
review of the available literature evaluating surgical outcomes after chronic distal biceps tendon rupture. Surgical techniques, including primary repair, autograft reconstruction, and allograft reconstruction, were compared, as well as subjective and objective clinical outcomes and complication rates.
UNASSIGNED: A systematic literature search of Level I-IV studies reporting outcomes of surgically treated chronic distal biceps tendon ruptures were performed via PubMed, Cochrane Collaboration, Science Direct, and Google Scholar databases. Twenty-two papers were identified in the
review, with 236 patients. A Modified Coleman Methodological Score (CMS) was determined for every article to assess study quality. Patient-reported outcomes, postoperative range of motion, flexion and supination strength, and postoperative complications were recorded. MAYO elbow scores (MEPS) were reported more consistently than the other outcome tools.
UNASSIGNED: No Level I or level II studies were identified in our search, and the heterogeneity of outcome measures precluded meta-analysis. Studies demonstrated mean MEPS scores ranging between 86 and 100, regardless of the surgical technique utilized. All studies reported a mean flexion-extension arc equal to or greater than 5-130°. The reported mean postoperative flexion strength was within 10% of the unaffected contralateral side. The most common complication for both direct repair and reconstruction groups was paresthesia of the lateral antebrachial cutaneous nerve [direct repair: 18-16.8%; reconstruction: 8-6.2% (allograft: 4-6%; autograft: 4-7%)]. Rerupture was uncommon and occurred in three patients who had undergone direct repair and in one patient after autograft reconstruction.
UNASSIGNED: Surgical treatment of chronic distal biceps injuries yields favorable objective and subjective outcomes. Currently, available evidence suggests that direct repair, autograft reconstruction, or allograft reconstruction are all viable treatment options with similar outcomes.