缝合锚钉和阔筋膜同种异体移植治疗三头远端肌腱慢性撕裂:病例报告、手术技术和文献回顾

IF 4.5 Q1 EDUCATION & EDUCATIONAL RESEARCH Techniques in Shoulder and Elbow Surgery Pub Date : 2020-08-14 DOI:10.1097/BTE.0000000000000197
E. Bonicoli, M. Giuntoli, E. Ipponi, P. Battaglia, I. Angelini, M. Scaglione
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引用次数: 0

摘要

慢性撕裂的远端三头肌腱是极其罕见的病变。外科治疗可以直接将病变的两侧重新附着,或者在肌腱明显缩回的情况下,使用移植物填补由此产生的间隙。在这里,我们报告一个病例撕裂远端肱三头肌腱发生在一个33岁的病人患截瘫。由此造成的肘部功能损伤阻碍了她使用轮椅,严重限制了她的行动能力和自主性。术前进行临床评估、x光片、肌肉-肌腱超声和磁共振成像。考虑到手术时挛缩6厘米,我们使用缝合锚钉(5毫米Super Reevo ConMed)和尸体阔筋膜异体移植物组合重建肌腱。手术后,肘关节在臂-掌骨石膏内伸展固定30天。在接下来的一个月,用铰链肘关节支具替换石膏,并允许渐进式活动。术后5个月,患者恢复了先前的活动屈伸关节ROM,并能够再次使用轮椅。无并发症发生。
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Chronic Tear of the Distal Triceps Tendon Treated With Suture Anchors and Fascia Lata Allograft: Case Report, Surgical Technique and Literature Review
Chronic tears of the distal triceps tendon are extremely uncommon lesions. Surgical therapy can be performed with a direct reattachment of the 2 sides of the lesion or—in case of significant tendon retraction—using grafts to fill the resulting gap. Herein, we report a case of a torn distal triceps tendon that occurred in a 33-year-old patient suffering from paraplegia. The resulting functional impairment of the elbow impeded her to use a wheelchair, causing a substantial limitation to her mobility and autonomy. Preoperative clinical evaluation, x-rays, muscle-tendon ultrasound, and magnetic resonance imagingwas been performed. In consideration of a 6 cm retraction at the surgery, we reconstructed the tendon using a combination of suture anchors (5 mm Super Reevo ConMed) and a cadaver fascia lata allograft. After surgery, the elbow was immobilized in extension inside a brachio-metacarpal cast for 30 days. In the following month, the cast was replaced with a hinged elbow brace and progressive mobilization was permitted. Five months postoperatively, the patient regained her previous active flexion-extension articular ROM and was able to use her wheelchair again. No complication occurred.
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期刊介绍: Published quarterly, Techniques in Shoulder & Elbow Surgery escorts the reader into the operating room and supplies step-by-step details of exciting and advanced techniques. It explains the evolution of and rationale for the procedures, identifies the pitfalls and possible complications, provides invaluable tips for improving surgical results and it is illustrated cover to cover with high-quality intraoperative photographs and drawings, many in full color.
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