■肱二头肌肌腱固定术(BT)在肱骨近端骨折(PHFs)的切开复位内固定(ORIF)中的作用尚不清楚。接受ORIF的患者中有一部分持续疼痛,病因不明。我们研究的目的是比较有和没有伴随BT的PHFs的ORIF结果。我们假设在ORIF时接受BT的患者将改善患者报告的结果评分,而与二头肌治疗相关的次要程序较少。
■在这项回顾性队列研究中,我们对2019年1月至2022年6月在单一一级创伤中心接受PHFORIF治疗的所有患者进行了回顾.18岁以下的患者被排除在外。主要结果是患者报告结果测量信息系统身体功能,抑郁症,和5个时间点的疼痛干扰评分,直至最终随访。次要结果包括总手术时间,并发症,后续程序,类固醇注射,和运动范围。对分类值进行卡方检验,对连续变量进行配对t检验。
■71例患者符合纳入标准:41例接受ORIF而不接受BT,30例接受ORIF而接受BT。平均随访时间为11个月。组间患者的人口统计学差异无统计学意义。术后任何时间点患者报告的结果测量信息系统评分均无差异。在最终随访中,BT组的ORIF患者前屈高于未接受BT的患者(142vs.123度,分别,P<.02)。手术时间没有差异,修订率,术后并发症,或术后组间注射。
■在PHFs的ORIF期间进行BT并没有导致组间功能或患者报告结果的显著差异,除了在最后随访时更大的前弯。虽然BT在重度PHF中更常见,两组患者随后的肱二头肌相关手术和翻修手术的发生率相似.
UNASSIGNED: The role of biceps tenodesis (BT) during open reduction internal fixation (ORIF) of proximal humerus fractures (PHFs) remains unclear. A subset of patients undergoing ORIF have persistent pain with unclear etiology. The purpose of our study was to compare outcomes of ORIF of PHFs with and without concomitant BT. We hypothesize patients undergoing BT at the time of ORIF will have improved patient-reported outcome scores with fewer secondary procedures related to treatment of the biceps.
UNASSIGNED: In this retrospective cohort study, all patients undergoing ORIF for a PHF at a single level one trauma center from January 2019 to June 2022 were reviewed. Patients under the age of 18 were excluded. Primary outcomes were patient-reported outcomes measurement information system physical function, depression, and pain interference scores at 5 time points up to final follow-up. Secondary outcomes included total operative time, complications, subsequent procedures, steroid injections, and range of motion. Chi-square tests were performed for categorical values and paired t-tests for continuous variables.
UNASSIGNED: 71 patients met inclusion criteria: 41 undergoing ORIF without BT and 30 undergoing ORIF with BT. Average follow-up was 11 months. There were no statistically significant differences in patient demographics between groups. There were no differences in patient-reported outcomes measurement information system scores at any time point postoperatively. At final follow-up patients in the ORIF with BT group had higher forward flexion than those who did not undergo BT (142 vs. 123 degrees, respectively, P < .02). There were no differences in surgical time, revision rates, postsurgical complications, or postoperative injections between groups.
UNASSIGNED: BT performed during ORIF of PHFs did not result in significantly different functional or patient-reported outcomes between groups, except for greater forward flexion at final follow-up. Although BT was done more commonly in severe PHFs, patients in both groups had similar rates of subsequent biceps-related procedures and revision surgery.