Surgical treatment of acute biceps tendon ruptures with a suture anchor.

Department of Orthopaedics and Sports Traumatology, Aalsters Stedelijk Ziekenhuis, Aalst, Belgium.
Acta orthopaedica Belgica (Impact Factor: 0.63). 02/1993; 59(4):426-9.
Source: PubMed

ABSTRACT Fixation of acute proximal and distal biceps tendon ruptures can be facilitated by the use of suture anchors. Originally designed for open Bankart procedures, suture anchors provide adequate fixation for soft tissue healing, limit the extent of dissection, reduce the incidence of frozen shoulder and damage to neurovascular structures and allow early postoperative rehabilitation. Four consecutive patients were successfully treated by this method with a minimum follow-up period of 1 year.

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    ABSTRACT: We present a retrospective review of six cases of distal biceps tendon repair with a mean follow-up of 1 year. All patients were men aged between 34 and 62 years. In all patients, the injury was sustained with application of an unanticipated large load to the flexed arm. All but one patient was operated within a week of the injury. All six cases were operated through a single anterior incision and the torn tendon ends fixed to the radial tuberosity with implantable suture anchors. All patients were reviewed subjectively and objectively. All but one returned to preinjury activity within 6 months. One patient developed superficial radial nerve neurapraxia, which recovered, and one developed a superficial wound infection, which required treatment with oral antibiotics and surgical excision of the sinus. We believe that operative repair of distal biceps tendon rupture using a single anterior incision and suture anchors is a safe and effective method of treating theses injuries.Nous prsentons une tude rtrospective de six cas de rparation distale du tendon de biceps avec un recul moyen dun an. Tous les patients taient des hommes gs entre 34 et 62 ans. Chez tous les patients, la lsion stait produite par mise en charge excessive et non anticipe du bras flchi . Tous sauf un patient ont t oprs dans un dlai dune semaine partir de la lsion initiale. Chacun des six cas a t opr par une incision antrieure et refixation du tendon dsinsr sur la tubrosit tibiale par utilisation dancres pour os. Tous les patients ont t revus subjectivement et objectivement. Tous sauf ont repris leur activit antrieure en moins de six mois. Un patient a dvelopp une neuropraxie du nerf radial superficie, qui a rcuprl, et un autre a dvelopp une infection superficielle de la plaie, qui a ncessit une antibiothrapie et une excision chirurgicale. Nous pensons que la rparation de larrachement du tendon bicipital par simple incision antrieure et refixation par ancrage osseux est une mthode fiable et efficace pour le traitement de cette lsion.
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    ABSTRACT: Posterior interosseous nerve palsy is a recognized complication of 2-incision distal biceps tendon repair. We hypothesize that intraoperative forearm pronation can cause compression of the posterior interosseous nerve beneath the supinator and arcade of Frohse. Six human male cadaver upper extremities were dissected. Pressure on the posterior interosseous nerve beneath the arcade of Frohse and supinator was measured with a Swan-Ganz catheter connected to a pressure transducer. Pressure was significantly elevated in maximal pronation in all specimens with the elbow in both flexion and extension. Pressures at full pronation were significantly higher than pressures measured at 60 degrees of pronation (5 +/- 2 mm Hg in 60 degrees of pronation and 90 degrees of flexion, P < .0001; 7 +/- 3 mm Hg in 60 degrees of pronation and extension, P < 005). Maximal pronation can cause increased pressure on the posterior interosseous nerve. The safety of 2-incision distal biceps repair may be increased by avoiding prolonged, uninterrupted periods of hyperpronation.
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