Distal Biceps and Triceps Tendon Ruptures

Perera, Lahiru; Watts, Adam C.; Bain, Gregory I.

doi:10.1016/b978-0-7020-3099-4.00037-0

Cited by 2 publications

(2 citation statements)

References 53 publications

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“…Концепции лечения разрывов ДСДМП варьируются в зависимости от сроков давности травмы, площади поражения сухожилия, наличия морфологических девиаций локтевого сустава (гетеротопическая оссификация, кубартроз, нейропатия), индекса коморбидности и функциональных запросов пациента и делятся на консервативную и хирургическую [2,5,11,14,20,21]. Редкость нозологической формы и отсутствие единых клиникодиагностических алгоритмов лечения побудило нас к проведению исследования, охватившего период в десять лет.…”

Section: Discussionunclassified

“…Внедрение в клиническую практику визуализирующих методов инструментальной диаг ностики, таких как МРТ 1,5-3,0 Tл и МСКТ с 3D-рекон струкцией, адресных клинических тестов (супинационно-пронационный, тест пассивной пронации предплечья, тест O'Driscoll, тест Ruland, измерение интервала сгибания бицепса и коэффициента складки бицепса, тест на изгиб lacertus fibrosus) и клинико-диагностических алгоритмов позволяют врачам точно определять концепцию лечения на догоспитальном этапе [2]. С другой стороны, вариабельный набор малоинвазивных опций (double incision доступов, гибкого инструментария) и эволюция кортикальных имплантатов делают хирургию безопаснее, а «анатомическая» классификация L. Perera [11] и «диагностическая» классификация J. Fuente [12] обеспечивают дифференцированный подход при разрывах, сочетанных с lacertus fibrosus или выраженной мышечной ретракцией, повышая конечную эффективность метода [13,14,15,16].…”

Section: Introductionunclassified

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Biceps Brachii Distal Tendon Ruptures: Conservative and Surgical Treatment Outcomes

Medvedchikov

Anastasieva

Корыткин

et al. 2022

Traumatology and Orthopedics of Russia

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Background. Interest in the study of the distal biceps brachii tendon ruptures in the recent decade has been caused by the development of instrumental diagnostic methods, the new sports disciplines appear and by the technological workplace environment complication. The main concepts of treatment depend on the injury term, the tendon tissue damage area, the patient functional needs and his/her professional activities, the comorbidity index (CCI), so the concepts are divided into two: conservative and surgical. The aim of the study to identify the most effective method of treating patients with a biceps brachii distal tendon rupture. Methods. The study included 58 patients (all men) with a biceps brachii distal tendon injury. They were divided into groups depending on the concept of treatment: a conservative treatment group 20 (34%) patients and a surgical treatment group 38 (66%). The surgical treatment group was also divided into subgroups according to surgical approaches, reinsertion methods and types of fixation. Patients underwent physical tests (ODriscoll, Ruland, et al.), ultrasound to compare the proximal radio-ulnar space, degree of muscle retraction, lacertus fibrosus involvement, and MRI of the elbow joint. The functional scales VAS, DASH and ASES were used to evaluate the obtained results. The results of instrumental diagnostic methods were evaluated with the L. Perera (2012) and J. Fuente (2018) classifications. Results. Evaluation of the results in the groups of surgical (Ns) and conservative (Nc) treatment according to functional scales after 6 (VAS, DASH) and 36 months (ASES) revealed: a decrease in subjective pain score 1 point, a decrease in DASH to 21 and 43 points (statistically significant decrease in both groups p0.001, difference between groups p = 0.005), ASES: 91 and 71 points (dynamics in both groups and difference between groups p 0.001). Minimally invasive approaches compared with open access (nD) showed better functional outcomes according to the DASH scale: nBA vs nD p = 0.006; nMA vs nD p = 0.013 after 6 months, and according to the ASES scale: nBA vs nD p = 0.007; nBA vs nD p= 0.002 after 36 months. An reinsertion methods intragroup analysis revealed the achievement of peak indicators by 6 weeks without complications in the anatomical variant according to the VAS: nBA vs nMA p = 0.264; DASH: nBA vs nMA p = 0.856; ASES nBA vs nMA p = 0.179. Conclusion. Comparison within subgroups made it possible to identify the most effective technique combination of minimally invasive access with an anatomical version of intracanal fixation with a cortical button. This technique has shown to have a low risk of postoperative complications.

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Section: Discussionunclassified

Section: Introductionunclassified

Biceps Brachii Distal Tendon Ruptures: Conservative and Surgical Treatment Outcomes

Medvedchikov

Anastasieva

Корыткин

et al. 2022

Traumatology and Orthopedics of Russia

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Providing specialized care to patients with a rupture of the distal tendon of the biceps brachii: diagnosis and treatment algorithm

Medvedchikov

Anastasieva

Корыткин

et al. 2022

Acta biomedica scientifica

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Biceps brachii distal tendon injury is rare, 2.55–5.35 per 100,000. This nosological form did not have a gender modality and was previously found mainly in middle-aged men (46.3 y.o.). By 2022, this injury “rejuvenated” and began to occur more often, covering the categories of juniors and young athletes, whose professional activities have expanded significantly with the advent of new power disciplines, contact sports and popularization of bodybuilding. The authors note the negative impact of smoking and the use of anabolic steroids, statins and obesity on the incidence of these lesions. The maximum supination force in this type of injury is reduced by an average of 40 %, and the maximum flexion force is reduced by an average of 20 %. Considering the significance of functional disorders not only of the elbow joint, but also of motor patterns of the entire upper limb girdle for professional athletes, sports-organized people and people involved in the physical aspects of labor, surgical treatment is recommended. Nonsurgical treatment can be aimed at suppressing edema and inflammation, limiting early movements in the elbow joint and increasing secondary muscle tension, and it is suitable for patients with low functional demand, poor compliance and high risks of both surgical treatment and anesthesia care. That is, the choice of treatment tactics is still based, in addition to anatomical changes and on the “subjective” patient data, his/her needs for physical activity and requires an algorithmic approach in order to avoid both known complications and confidently predict a positive result during the prehospital period. Based on ten years of clinical and practical experience adjusted by widely available scientific periodicals, we have developed a scheme that is understandable to every specialist in the field of traumatology, orthopedics or sports medicine, and is applicable regardless of the medical institution level. For the first time, this scheme was published in this work.

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Distal Biceps and Triceps Tendon Ruptures

Cited by 2 publications

References 53 publications

Biceps Brachii Distal Tendon Ruptures: Conservative and Surgical Treatment Outcomes

Biceps Brachii Distal Tendon Ruptures: Conservative and Surgical Treatment Outcomes

Providing specialized care to patients with a rupture of the distal tendon of the biceps brachii: diagnosis and treatment algorithm

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