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Reconstruction of chronic tearing of the distal triceps using the double-row configuration: technical note

机译:使用双行配置重建肱三头肌的慢性撕裂:技术说明

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摘要

Tearing of the distal triceps is uncommon and may be difficult to diagnose, especially in situations of partial tearing. Imaging methods such as ultrasonography and magnetic resonance imaging should be used to confirm the diagnosis and define the extent of the injury. The preferred treatment for complete tearing of the triceps is surgical, unlike in cases of partial tearing, in which the treatment depends on factors such as pain, functional deficit and the patient's expectations. Here, we describe the case of a patient with partial tearing of the distal triceps after falling to the ground, which was not diagnosed at the time of first attendance and evolved with pain and great functional loss. The surgical procedure was performed nine months after the injury, with reconstruction of the triceps by means of reinforcement using the tendon of the ipsilateral semitendinosus and fixation in the olecranon using the double-row configuration. The patient remained immobilized using a sling for one week and then gains in passive range of motion (ROM) were introduced. Three weeks later, the patient was released for gains in active ROM. Muscle strengthening was started after 12 weeks. Six weeks after the surgical procedure, the patient was free from pain and presented complete ROM, grade V elbow extension force and hypertrophy of the triceps. The technique described here was shown to be useful for treating tears of the tendon of the distal triceps.
机译:远端三头肌撕裂很少见,可能难以诊断,尤其是在部分撕裂的情况下。应使用超声检查和磁共振成像等成像方法来确认诊断并确定损伤程度。完全撕开肱三头肌的首选治疗方法是外科手术,这与部分撕裂的情况不同,在这种情况下,治疗取决于诸如疼痛,功能障碍和患者期望等因素。在这里,我们描述了一个患者跌落到地面后远端肱三头肌局部撕裂的情况,这种情况在初次就诊时并未被诊断出,并伴有疼痛和严重的功能丧失。外科手术是在受伤后九个月进行的,通过使用同侧半腱肌腱进行加强来重建肱三头肌,并使用双行构造将其固定在鹰嘴中。使用悬带将患者保持固定状态一周,然后引入被动运动范围(ROM)。三周后,患者因活动ROM获释而被释放。 12周后开始加强肌肉。手术后六周,患者没有疼痛,并表现出完全的ROM,V级肘部伸展力和肱三头肌肥大。已显示此处描述的技术可用于治疗远端三头肌腱撕裂。

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