The effect of biceps reattachment site

被引:45
作者
Schmidt, Christopher C. [1 ,2 ]
Weir, David M. [2 ,5 ]
Wong, Andrew S. [3 ]
Howard, Michael [4 ]
Miller, Mark Carl [2 ,5 ]
机构
[1] Allegheny Gen Hosp, Dept Orthopaed, Div Upper Extrem Surg, Pittsburgh, PA 15212 USA
[2] Allegheny Gen Biomech Lab, Pittsburgh, PA USA
[3] Loma Linda Univ, Med Ctr, Redlands, CA USA
[4] David Grant Med Ctr, Dept Orthopaed, Travis AFB, CA USA
[5] Univ Pittsburgh, Swanson Sch Engn, Pittsburgh, PA USA
关键词
Distal biceps tendon; supination torque; supination moment arm; tendon attachment location; biceps rupture; biceps tendon repair; TENDON RUPTURES; BRACHII TENDON; SUTURE ANCHOR; DISTAL TENDON; ANATOMIC REINSERTION; SURGICAL REPAIR; MOMENT ARMS; FOLLOW-UP; STRENGTH; FOREARM;
D O I
10.1016/j.jse.2010.05.027
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: We hypothesize that an anatomic repair of the distal biceps tendon would recreate native tendon moment arm and forearm rotation, while a nonanatomic insertion would compromise moment arm and forearm rotation. Methods: Isometric supination torque was measured at 60 degrees of pronation, neutral, and 60 degrees of supination for the native distal biceps tendon and 4 repair points in 6 cadaveric specimens using a computer controlled elbow simulator. The slope of the regression line fitted to the torque versus biceps load data was used to define the moment arm for each attachment location. Range of motion testing was performed by incrementally loading the biceps, while measuring the supination motion generated using a digital goniometer. Results: Tendon location and forearm position significantly affected the moment arm of the biceps (P < .05). Anatomic repair in all forearm positions showed no significant difference from the native insertion. Moment arm for an anterior center repair was significantly lower in supination (-97%) and neutral (-27%) and also produced significantly less supination motion. No difference was observed between all tendon locations in pronation. Conclusions: Reattachment of the biceps to its anatomic location, as opposed to a more anterior central position, is critical in reestablishing native tendon biomechanics. Clinically, these findings would suggest that patients with a biceps repair might experience the most weakness in a supinated position without experiencing a deficit in the pronated forearm.
引用
收藏
页码:1157 / 1165
页数:9
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