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Reconstruction of delayed diagnoses simultaneous bilateral distal biceps tendon ruptures using semtendinosus and quadriceps tendon autografts.

Blønd L, Kaewkongnok B - Springerplus (2015)

Bottom Line: At follow-up 14 month postoperatively the Oxford Elbow Score was 92 percent for both elbows and the MRI's bilaterally demostrates that the grafts are tight.Based on the experience from this case it is concluded that six weeks after trauma the degree of retraction of the distal biceps tendon can impair direct repair.When reconstruction of the ruptured distal biceps tendon is needed, subjective normal forces can be obtained using both the semitendosus graft as well as the quadriceps graft, however with a minor increased donor site morbidity with respect to the quadriceps graft.

View Article: PubMed Central - PubMed

Affiliation: Teres Hospital Parken, Øster Alle 42, 3, DK-2100 Copenhagen, Denmark ; University Hospital of Køge, Lykkebækvej 1, DK-4600 Køge, Denmark.

ABSTRACT

Introduction: Simultaneous bilateral distal biceps rupture is rarely reported, but several issues has to be taken into account and the here presented case brings up some of these aspects.

Case description: This case presents a simultaneous bilateral distal biceps ruptures, and due to delayed diagnosis, bilateral muscle retraction had occurred. Surgical reconstruction was challenged both by social circumstances and by previous harvesting of the Semitendinous tendon on one side. The surgery was performed as a staged approach, using a Semitendinosus graft at one side and later using a Quadriceps tendon graft on the opposite site. At follow-up 14 month postoperatively the Oxford Elbow Score was 92 percent for both elbows and the MRI's bilaterally demostrates that the grafts are tight.

Discussion and evaluation: The Quadriceps tendon is a previously non reported type of graft material for this type of surgery. Based on the experience from this case it is concluded that six weeks after trauma the degree of retraction of the distal biceps tendon can impair direct repair.

Conclusion: When reconstruction of the ruptured distal biceps tendon is needed, subjective normal forces can be obtained using both the semitendosus graft as well as the quadriceps graft, however with a minor increased donor site morbidity with respect to the quadriceps graft.

No MeSH data available.


Related in: MedlinePlus

Postoperative MRI at 14 month follow-up demonstrate well proportioned and tight grafts bilaterally. Right elbow is semtendinosus graft and left elbow is quadriceps graft.
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Fig2: Postoperative MRI at 14 month follow-up demonstrate well proportioned and tight grafts bilaterally. Right elbow is semtendinosus graft and left elbow is quadriceps graft.

Mentions: At 4–5 month follow-up, normal range of movement had been achieved and muscle strength was subjectively recovered. The biceps muscle belly appeared displaced a few centimeters proximal bilaterally. See Figure 1a, b and c. He report that the donor site morbidity has been significantly less from the semitendinosus donor site compared to the quadriceps donor site and especially for the first 6 month postoperatively, he experienced significantly more pain in the quadriceps area compared to the opposite hamstrings area, and this pain affected his physiotherapeutic progression and the level of sports activity when bicyling. At 12 month follow-up he has obtained normal sports activities, but he experienced minor sore from the quadriceps donor site. At follow-up 14 month postoperatively the Oxford Elbow Score was 92 percent for both elbow and the MRI’s bilaterally demostrate that the grafts are tight. See Figure 2.Figure 1


Reconstruction of delayed diagnoses simultaneous bilateral distal biceps tendon ruptures using semtendinosus and quadriceps tendon autografts.

Blønd L, Kaewkongnok B - Springerplus (2015)

Postoperative MRI at 14 month follow-up demonstrate well proportioned and tight grafts bilaterally. Right elbow is semtendinosus graft and left elbow is quadriceps graft.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356679&req=5

Fig2: Postoperative MRI at 14 month follow-up demonstrate well proportioned and tight grafts bilaterally. Right elbow is semtendinosus graft and left elbow is quadriceps graft.
Mentions: At 4–5 month follow-up, normal range of movement had been achieved and muscle strength was subjectively recovered. The biceps muscle belly appeared displaced a few centimeters proximal bilaterally. See Figure 1a, b and c. He report that the donor site morbidity has been significantly less from the semitendinosus donor site compared to the quadriceps donor site and especially for the first 6 month postoperatively, he experienced significantly more pain in the quadriceps area compared to the opposite hamstrings area, and this pain affected his physiotherapeutic progression and the level of sports activity when bicyling. At 12 month follow-up he has obtained normal sports activities, but he experienced minor sore from the quadriceps donor site. At follow-up 14 month postoperatively the Oxford Elbow Score was 92 percent for both elbow and the MRI’s bilaterally demostrate that the grafts are tight. See Figure 2.Figure 1

Bottom Line: At follow-up 14 month postoperatively the Oxford Elbow Score was 92 percent for both elbows and the MRI's bilaterally demostrates that the grafts are tight.Based on the experience from this case it is concluded that six weeks after trauma the degree of retraction of the distal biceps tendon can impair direct repair.When reconstruction of the ruptured distal biceps tendon is needed, subjective normal forces can be obtained using both the semitendosus graft as well as the quadriceps graft, however with a minor increased donor site morbidity with respect to the quadriceps graft.

View Article: PubMed Central - PubMed

Affiliation: Teres Hospital Parken, Øster Alle 42, 3, DK-2100 Copenhagen, Denmark ; University Hospital of Køge, Lykkebækvej 1, DK-4600 Køge, Denmark.

ABSTRACT

Introduction: Simultaneous bilateral distal biceps rupture is rarely reported, but several issues has to be taken into account and the here presented case brings up some of these aspects.

Case description: This case presents a simultaneous bilateral distal biceps ruptures, and due to delayed diagnosis, bilateral muscle retraction had occurred. Surgical reconstruction was challenged both by social circumstances and by previous harvesting of the Semitendinous tendon on one side. The surgery was performed as a staged approach, using a Semitendinosus graft at one side and later using a Quadriceps tendon graft on the opposite site. At follow-up 14 month postoperatively the Oxford Elbow Score was 92 percent for both elbows and the MRI's bilaterally demostrates that the grafts are tight.

Discussion and evaluation: The Quadriceps tendon is a previously non reported type of graft material for this type of surgery. Based on the experience from this case it is concluded that six weeks after trauma the degree of retraction of the distal biceps tendon can impair direct repair.

Conclusion: When reconstruction of the ruptured distal biceps tendon is needed, subjective normal forces can be obtained using both the semitendosus graft as well as the quadriceps graft, however with a minor increased donor site morbidity with respect to the quadriceps graft.

No MeSH data available.


Related in: MedlinePlus