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      Retrospective Evaluation of Surgical Anatomical Repair of Distal Biceps Brachii Tendon Rupture Using Suture Anchor Fixation

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          Abstract

          Background

          To date, no consensus has been reached regarding the preferred fixation method to use in the repair of distal biceps brachii tendon rupture. The aim of this study was to clinically and functionally (Mayo Elbow Performance Index, MEPI) assess the upper limb after surgical anatomic reinsertion of the distal biceps brachii tendon with the use of suture anchor fixation method with regard to postoperative time and limb dominance, and to assess postoperative complications.

          Material/Methods

          The sample comprised 18 males (age 52.09±8.89 years) after surgical anatomical distal biceps brachii reinsertion using suture anchor fixation. A comprehensive clinical and functional evaluation and pain assessment were performed.

          Results

          In terms of postoperative complications, an isolated case of surgical site sensory disturbances was noted. Circumferences (p-value 0.21–1.00) and ROM (p-value 0.07–1.00) were similar in the operated and nonoperated limbs. The isometric torque (IT) values of muscles flexing and supinating the forearm were comparable in both limbs (p-value 0.14–0.95), but in patients with the operated dominant limb, the mean IT value was not higher than the value obtained in the nonoperated nondominant one. The MEPI indicated good and excellent results (80.00±15.00–90.00±8.66 points), but a detailed individual analysis showed that reported scores were not in line with objectively measured features.

          Conclusions

          The results of the comprehensive retrospective evaluation justify the clinical use of suture anchors fixation method in the surgical anatomical reinsertion of a ruptured distal biceps brachii tendon. The assessment of a patient should always report both subjective and objective measures.

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          Most cited references49

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          Remark AS R94: A Remark on Algorithm AS 181: The W-test for Normality

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            Rupture of the distal tendon of the biceps brachii. A biomechanical study.

            In biomechanical studies on ten patients who had had a rupture of the distal tendon of the biceps brachii, we compared the results of immediate anatomical reattachment, delayed reattachment, and conservative treatment. When the tendon was simply attached to the brachialis muscle (one patient), there was nearly normal strength in elbow flexion but about 50 per cent loss of forearm supination. Late reinsertion (one patient) improved strength of both flexion and supination, but not to normal. Immediate reattachment (four patients) restored normal strength in flexion and supination at one year but not at four months (one patient). With conservative treatment (three patients) there was a mean loss of 40 per cent of supination strength and variable loss of flexion strength, averaging 30 per cent. These data suggest that immediate surgical reinsertion of the biceps tendon into the radial tuberosity, compared with other modes of treatment, restores more strength of flexion and supination.
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              Distal biceps tendon ruptures: incidence, demographics, and the effect of smoking.

              The purpose of the current study was to determine the incidence of distal biceps tendon ruptures within a defined population, to describe the demographics of affected individuals, and to identify potential risk factors. The healthcare system in this study provides care to a known number of members in an area defined by zip codes and proximity to the medical center. Medical records for all members who presented with injuries about the elbow during a 5-year period were reviewed. Thirteen men and one woman with an average age of 47 years comprised the study population. The dominant extremity was involved in 86% of patients. All patients described a mechanism involving excessive eccentric tension as the arm was forced from a flexed position. The incidence of injury in the membership population averaged 1.2 ruptures per 100,000 patients per year. Forty-three percent reported regular tobacco use, whereas only 9% of all members were smokers. A Poisson regression analysis revealed a 7.5 times greater risk of distal biceps tendon rupture in patients who smoke. The incidence of distal biceps tendon ruptures is 1.2 per 100,000 patients, with the majority in the dominant elbow of men who smoke and who are in their fourth decade of life.
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                Author and article information

                Journal
                Med Sci Monit
                Med. Sci. Monit
                Medical Science Monitor
                Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
                International Scientific Literature, Inc.
                1234-1010
                1643-3750
                2017
                17 October 2017
                : 23
                : 4961-4972
                Affiliations
                [1 ]Department and Clinic of Traumatology and Hand Surgery, Medical University, Wrocław, Poland
                [2 ]Department of Physiotherapy, The College of Physiotherapy in Wrocław, Wrocław, Poland
                Author notes
                Corresponding Author: Paweł Reichert, e-mail: pawelreichert74@ 123456gmail.com
                [A]

                Study Design

                [B]

                Data Collection

                [C]

                Statistical Analysis

                [D]

                Data Interpretation

                [E]

                Manuscript Preparation

                [F]

                Literature Search

                [G]

                Funds Collection

                Article
                903723
                10.12659/MSM.903723
                5656101
                29040248
                6c9ce31c-5562-43fb-b9ba-a406286c20fb
                © Med Sci Monit, 2017

                This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International ( CC BY-NC-ND 4.0)

                History
                : 10 February 2017
                : 19 April 2017
                Categories
                Clinical Research

                elbow joint,isometric contraction,soft tissue injuries,torque

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