[Surgical treatment of distal triceps tendon ruptures].

IF 1 4区医学 Q3 ORTHOPEDICS Operative Orthopadie Und Traumatologie Pub Date : 2022-12-01 DOI:10.1007/s00064-022-00781-8

Mathias Ritsch, Markus Regauer, Christian Schoch

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引用次数: 1

Abstract

Objective: Restoration of the anatomy and the original length of the muscle-tendon unit in triceps tendon ruptures.

Indications: Acute and chronic triceps tendon ruptures with persisting symptoms and significant strength deficits.

Contraindications: Infections and tumors in the surgical area.

Surgical technique: Prone position. Skin incision over the distal triceps in a lateral direction around the olecranon. Mobilization of the tendon and débridement of the olecranon. Drilling of 2 × 2.9 mm suture anchor holes medial and lateral into the footprint of the olecranon. In addition, drilling through the olecranon 12 mm distal to the tip of the olecranon and transosseous introduction of 4 sutures. Then the suture anchors (all-suture or titanium anchors) are inserted into the drill holes. Refix the deep and superficial tendons with the anchor threads. Refix the upper tendon portions with the transosseous sutures. In the case of chronic lesions, a graft interposition is necessary.

Postoperative management: Dorsal 10 ° splint, then change to an orthosis fixed in 20 ° extension and passive mobility 0-30 ° flexion for 6 weeks. From the 7th week onwards, load-free, physiotherapeutically controlled increasing mobilization. Starting weight-loading from the 13th week on. Full load after 6 months.

Results: In all, 34 male strength athletes with acute triceps tendon rupture underwent surgery using the hybrid technique described and were prospectively recorded. The MEPS‑G score averaged 94.7 points, there were no permanent limitations in mobility, and the postoperative strength ability averaged 94% of the original strength performance ability. The return to sport achieved 100%. The complication rate was 20.6%. Reconstruction of the distal triceps tendon using hybrid technology leads to very good functional results. Half of all patients complained of symptoms even before the rupture, which suggests previous damage to the distal triceps tendon caused by degeneration.

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[三头肌腱远端断裂的外科治疗]。

目的:恢复肱三头肌肌腱断裂的解剖结构和原肌-肌腱单元长度。适应症:急性和慢性三头肌腱断裂，持续症状和明显的力量不足。禁忌症:手术部位的感染和肿瘤。手术手法:俯卧位。在远端三头肌上的皮肤切口，在鹰嘴周围的外侧方向。肌腱的活动和鹰嘴的损伤。在鹰嘴内侧和外侧钻孔2个 × 2.9 mm缝合锚孔。此外，在鹰嘴尖端远端12 mm处钻孔并经骨引入4条缝合线。然后将缝合锚钉(全缝合或钛锚钉)插入钻孔中。用锚线重新固定深层和浅层肌腱。用经骨缝合线重新固定上肌腱部分。在慢性病变的情况下，移植物介入是必要的。术后处理:背部10 °夹板，然后改为矫形器固定在20 °伸展和被动活动0-30°屈曲6周。从第7周开始，无负荷，物理治疗控制活动增加。从第13周开始负重训练。6个月后满载。结果:共有34名患有急性肱三头肌肌腱断裂的男性力量运动员采用上述混合技术进行了手术，并进行了前瞻性记录。MEPS - G评分平均为94.7分，无永久性活动受限，术后力量表现能力平均为原始力量表现能力的94%。运动回归率达到100%。并发症发生率为20.6%。使用混合技术重建远端肱三头肌肌腱可获得非常好的功能效果。一半的患者甚至在断裂之前就有症状，这表明之前三头肌腱远端损伤是由退变引起的。

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来源期刊

Operative Orthopadie Und Traumatologie ORTHOPEDICS-

CiteScore

2.10

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Orthopedics and Traumatology is directed toward all orthopedic surgeons, trauma-tologists, hand surgeons, specialists in sports injuries, orthopedics and rheumatology as well as gene-al surgeons who require access to reliable information on current operative methods to ensure the quality of patient advice, preoperative planning, and postoperative care. The journal presents established and new operative procedures in uniformly structured and extensively illustrated contributions. All aspects are presented step-by-step from indications, contraindications, patient education, and preparation of the operation right through to postoperative care. The advantages and disadvantages, possible complications, deficiencies and risks of the methods as well as significant results with their evaluation criteria are discussed. To allow the reader to assess the outcome, results are detailed and based on internationally recognized scoring systems. Orthopedics and Traumatology facilitates effective advancement and further education for all those active in both special and conservative fields of orthopedics, traumatology, and general surgery, offers sup-port for therapeutic decision-making, and provides – more than 30 years after its first publication – constantly expanding and up-to-date teaching on operative techniques.