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Do the patients after surgical ruptured distal biceps brachii tendon reinsertion return to clinical and functional level of their age-mates?
Author(s):
Krolikowska Aleksandra (Poland)
Krolikowska Aleksandra (Poland)
Affiliations:
ESSKA Academy. Krolikowska A. 05/09/18; 209846; P20-1812 Topic: Elbow, Wrist and Hand
Dr. Aleksandra Krolikowska
Dr. Aleksandra Krolikowska
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Abstract
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Objectives: It is hard to find any studies comparing the patients after surgical treatment of the distal biceps tendon injuries to matched controls. The aim of the study was a comparative clinical and functional assessment of patients averagely 3.5 years after surgical anatomical distal biceps brachii reinsertion versus matched heathy individuals.

Methods: A 3.5-year prospective study that involved clinical and functional assessment of patients after primary unilateral surgical anatomical distal biceps brachii tendon reinsertion with the use of suture anchors (Group I, n=10) compared to healthy controls (Group II, n=10) matched in terms of gender, age, body mass, and body weight was conducted. All of the repaired tendons were ruptured traumatically, and all of the studied patients were treated acutely (2.75±0.96 days of interval between the injury and surgical treatment). In five patients in the Group I the involved limb was the dominant one. The outcomes assessed in both studied groups were active range of forearm motion (ROM), elbow and arm circumferences, visual analogue scale (VAS), Quick Disability of the Arm, Shoulder, and Hand (Quick DASH),forearm flexor and supinator muscle torques measured under isometric conditions, and isokinetic conditions with the angular velocity 180°/s. The maximal isometric (IT) and peak (PT) torques values were normalized to body mass, and expressed as relative torques (RIT, RPT). The test of normality (Shapiro-Wilk test), parametric t-test for dependent samples, parametric t-test for independent samples, analysis of variance test (one-way ANOVA), and Tukey's test were adequately used in the statistical analysis of studied parameters.

Results: The range of pronation was significantly lower in the involved limb in the Group II than in the noninvolved limb in the same group (p=0.030), and dominant (p=0.005) and nondominant (p=0.005) limbs in the Group II. Also, the range of supination was lower in the involved limb in the Group I comparing to dominant (p=0.010), and nondominant (p=0.001) limbs in the Group II. Even though there were found no intra-group differences in terms of the RIT of elbow flexors, the obtained vales were lower in the involved limb (Group I) comparing to the dominant (p=0.005), and nondominant limbs (p=0.039) in the Group II. In terms of RIT values of forearm supinators, the intra-group comparison in the Group I revealed lower values in the involved limb (p=0.043). The values obtained in the involved limb (Group I) were also lower comparing to the dominant limb in the Group II (p=0.006).

Conclusions: In general, the analysis of the clinical and functional outcomes of patients at an average of 3.5 years after surgical anatomic reinsertion of the distal biceps brachii tendon revealed their return to the level of age-mates, justifying the clinical usage of the method of treatment. However, in the limb after surgical ruptured distal biceps tendon treatment, persistent deficits of active range of pronation and supination were observed.

Keywords:
distal biceps tendon, muscle, tendon, reinsertion
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