The effect of biceps reattachment site.
نویسندگان
چکیده
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° of pronation, neutral, and 60° 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.
منابع مشابه
The Effect of Biceps Reattachment Site on Moment Arm
Avulsion of the distal biceps tendon from the tuberosity occurs mostly in middle-aged males resulting from eccentric loading of the flexed, supinated forearm [1]. When non-operative treatment is chosen, supination strength decreases by 50% and flexion strength is reduced by 35-40% [2]. Surgical repair has been shown to be a better alternative than non-operative treatments for restoration of str...
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ورودعنوان ژورنال:
- Journal of shoulder and elbow surgery
دوره 19 8 شماره
صفحات -
تاریخ انتشار 2010