Biceps Brachii Distal Tendon Ruptures: Conservative and Surgical Treatment Outcomes
Background. Interest in the study of the distal biceps brachii tendon ruptures in the recent decade has been caused by the development of instrumental diagnostic methods, the new sports disciplines appear and by the technological workplace environment complication. The main concepts of treatment dep...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | Russian |
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Vreden Russian Research Institute of Traumatology and Orthopedics
2022-12-01
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| Series: | Travmatologiâ i Ortopediâ Rossii |
| Subjects: | |
| Online Access: | https://journal.rniito.org/jour/article/viewFile/1997/pdf |
| _version_ | 1797901565394157568 |
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| author | Artem E. Medvedchikov Evgeniya A. Anastasieva Andrey A. Korytkin Vitaliy L. Lukinov Irina A. Kirilova |
| author_facet | Artem E. Medvedchikov Evgeniya A. Anastasieva Andrey A. Korytkin Vitaliy L. Lukinov Irina A. Kirilova |
| author_sort | Artem E. Medvedchikov |
| collection | DOAJ |
| description | Background. Interest in the study of the distal biceps brachii tendon ruptures in the recent decade has been caused by the development of instrumental diagnostic methods, the new sports disciplines appear and by the technological workplace environment complication. The main concepts of treatment depend on the injury term, the tendon tissue damage area, the patient functional needs and his/her professional activities, the comorbidity index (CCI), so the concepts are divided into two: conservative and surgical.
The aim of the study to identify the most effective method of treating patients with a biceps brachii distal tendon rupture.
Methods. The study included 58 patients (all men) with a biceps brachii distal tendon injury. They were divided into groups depending on the concept of treatment: a conservative treatment group 20 (34%) patients and a surgical treatment group 38 (66%). The surgical treatment group was also divided into subgroups according to surgical approaches, reinsertion methods and types of fixation. Patients underwent physical tests (ODriscoll, Ruland, et al.), ultrasound to compare the proximal radio-ulnar space, degree of muscle retraction, lacertus fibrosus involvement, and MRI of the elbow joint. The functional scales VAS, DASH and ASES were used to evaluate the obtained results. The results of instrumental diagnostic methods were evaluated with the L. Perera (2012) and J. Fuente (2018) classifications.
Results. Evaluation of the results in the groups of surgical (Ns) and conservative (Nc) treatment according to functional scales after 6 (VAS, DASH) and 36 months (ASES) revealed: a decrease in subjective pain score 1 point, a decrease in DASH to 21 and 43 points (statistically significant decrease in both groups p0.001, difference between groups p = 0.005), ASES: 91 and 71 points (dynamics in both groups and difference between groups p 0.001). Minimally invasive approaches compared with open access (nD) showed better functional outcomes according to the DASH scale: nBA vs nD p = 0.006; nMA vs nD p = 0.013 after 6 months, and according to the ASES scale: nBA vs nD p = 0.007; nBA vs nD p= 0.002 after 36 months. An reinsertion methods intragroup analysis revealed the achievement of peak indicators by 6 weeks without complications in the anatomical variant according to the VAS: nBA vs nMA p = 0.264; DASH: nBA vs nMA p = 0.856; ASES nBA vs nMA p = 0.179.
Conclusion. Comparison within subgroups made it possible to identify the most effective technique combination of minimally invasive access with an anatomical version of intracanal fixation with a cortical button. This technique has shown to have a low risk of postoperative complications. |
| first_indexed | 2024-04-10T09:03:56Z |
| format | Article |
| id | doaj.art-fa1c3459d3034795afc12d908e0634e0 |
| institution | Directory Open Access Journal |
| issn | 2311-2905 2542-0933 |
| language | Russian |
| last_indexed | 2024-04-10T09:03:56Z |
| publishDate | 2022-12-01 |
| publisher | Vreden Russian Research Institute of Traumatology and Orthopedics |
| record_format | Article |
| series | Travmatologiâ i Ortopediâ Rossii |
| spelling | doaj.art-fa1c3459d3034795afc12d908e0634e02023-02-21T09:41:31ZrusVreden Russian Research Institute of Traumatology and OrthopedicsTravmatologiâ i Ortopediâ Rossii2311-29052542-09332022-12-0128411412510.17816/2311-2905-19971244Biceps Brachii Distal Tendon Ruptures: Conservative and Surgical Treatment OutcomesArtem E. Medvedchikov0https://orcid.org/0000-0002-1271-9026Evgeniya A. Anastasieva1https://orcid.org/0000-0002-9329-8373Andrey A. Korytkin2https://orcid.org/0000-0001-9231-5891Vitaliy L. Lukinov3https://orcid.org/0000-0002-3411-508XIrina A. Kirilova4https://orcid.org/0000-0003-1911-9741Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. TsivyanNovosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. TsivyanNovosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. TsivyanNovosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. TsivyanNovosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. TsivyanBackground. Interest in the study of the distal biceps brachii tendon ruptures in the recent decade has been caused by the development of instrumental diagnostic methods, the new sports disciplines appear and by the technological workplace environment complication. The main concepts of treatment depend on the injury term, the tendon tissue damage area, the patient functional needs and his/her professional activities, the comorbidity index (CCI), so the concepts are divided into two: conservative and surgical. The aim of the study to identify the most effective method of treating patients with a biceps brachii distal tendon rupture. Methods. The study included 58 patients (all men) with a biceps brachii distal tendon injury. They were divided into groups depending on the concept of treatment: a conservative treatment group 20 (34%) patients and a surgical treatment group 38 (66%). The surgical treatment group was also divided into subgroups according to surgical approaches, reinsertion methods and types of fixation. Patients underwent physical tests (ODriscoll, Ruland, et al.), ultrasound to compare the proximal radio-ulnar space, degree of muscle retraction, lacertus fibrosus involvement, and MRI of the elbow joint. The functional scales VAS, DASH and ASES were used to evaluate the obtained results. The results of instrumental diagnostic methods were evaluated with the L. Perera (2012) and J. Fuente (2018) classifications. Results. Evaluation of the results in the groups of surgical (Ns) and conservative (Nc) treatment according to functional scales after 6 (VAS, DASH) and 36 months (ASES) revealed: a decrease in subjective pain score 1 point, a decrease in DASH to 21 and 43 points (statistically significant decrease in both groups p0.001, difference between groups p = 0.005), ASES: 91 and 71 points (dynamics in both groups and difference between groups p 0.001). Minimally invasive approaches compared with open access (nD) showed better functional outcomes according to the DASH scale: nBA vs nD p = 0.006; nMA vs nD p = 0.013 after 6 months, and according to the ASES scale: nBA vs nD p = 0.007; nBA vs nD p= 0.002 after 36 months. An reinsertion methods intragroup analysis revealed the achievement of peak indicators by 6 weeks without complications in the anatomical variant according to the VAS: nBA vs nMA p = 0.264; DASH: nBA vs nMA p = 0.856; ASES nBA vs nMA p = 0.179. Conclusion. Comparison within subgroups made it possible to identify the most effective technique combination of minimally invasive access with an anatomical version of intracanal fixation with a cortical button. This technique has shown to have a low risk of postoperative complications.https://journal.rniito.org/jour/article/viewFile/1997/pdfelbow jointbiceps brachiilacertus fibrosusdistal tendonsports medicinesurgical approachcortical button |
| spellingShingle | Artem E. Medvedchikov Evgeniya A. Anastasieva Andrey A. Korytkin Vitaliy L. Lukinov Irina A. Kirilova Biceps Brachii Distal Tendon Ruptures: Conservative and Surgical Treatment Outcomes Travmatologiâ i Ortopediâ Rossii elbow joint biceps brachii lacertus fibrosus distal tendon sports medicine surgical approach cortical button |
| title | Biceps Brachii Distal Tendon Ruptures: Conservative and Surgical Treatment Outcomes |
| title_full | Biceps Brachii Distal Tendon Ruptures: Conservative and Surgical Treatment Outcomes |
| title_fullStr | Biceps Brachii Distal Tendon Ruptures: Conservative and Surgical Treatment Outcomes |
| title_full_unstemmed | Biceps Brachii Distal Tendon Ruptures: Conservative and Surgical Treatment Outcomes |
| title_short | Biceps Brachii Distal Tendon Ruptures: Conservative and Surgical Treatment Outcomes |
| title_sort | biceps brachii distal tendon ruptures conservative and surgical treatment outcomes |
| topic | elbow joint biceps brachii lacertus fibrosus distal tendon sports medicine surgical approach cortical button |
| url | https://journal.rniito.org/jour/article/viewFile/1997/pdf |
| work_keys_str_mv | AT artememedvedchikov bicepsbrachiidistaltendonrupturesconservativeandsurgicaltreatmentoutcomes AT evgeniyaaanastasieva bicepsbrachiidistaltendonrupturesconservativeandsurgicaltreatmentoutcomes AT andreyakorytkin bicepsbrachiidistaltendonrupturesconservativeandsurgicaltreatmentoutcomes AT vitaliyllukinov bicepsbrachiidistaltendonrupturesconservativeandsurgicaltreatmentoutcomes AT irinaakirilova bicepsbrachiidistaltendonrupturesconservativeandsurgicaltreatmentoutcomes |