Challenges in tendon-bone healing: emphasizing inflammatory modulation mechanisms and treatment.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. 20. Injury. 2013 Mar;44(3):318-22. doi: 10.1016/j.injury.2013.01.003. Epub 2013 Jan 23. Distal biceps and triceps ruptures. Kokkalis ZT(1), Ballas EG(2), Mavrogenis AF(2), Soucacos PN(2). Author information: (1)Department of Orthopaedics, Orthopaedic Research & Education Center, National and Kapodistrian University of Athens, School of Medicine, "Attikon" University Hospital, Athens, Greece. Electronic address: zinon.kokkalis@hotmail.com. (2)Department of Orthopaedics, Orthopaedic Research & Education Center, National and Kapodistrian University of Athens, School of Medicine, "Attikon" University Hospital, Athens, Greece. Biceps and triceps tendon ruptures are rather uncommon injuries and are most commonly diagnosed clinically. Magnetic resonance imaging can help the clinician to differentiate an incomplete tear and define any degeneration of the tendon. Surgical anatomical repair is typically performed in acute complete ruptures whereas nonoperative treatment can be used for partial ruptures, as well as for patients unfit for surgery. Single incision techniques are associated with a higher rate of nerve injuries, while double incision repairs have a higher prevalence of heterotopic ossification. Although various fixation methods have been applied including bone tunnels, interference screws, suture anchors, cortical button fixation, the current evidence does not support the superiority of one method over the other. A well-planned postoperative rehabilitation programme is essential for a good final outcome. As better fixation devices are being used, more aggressive rehabilitation programmes have been applied. Epidemiology, clinical evaluation, diagnosis, surgical and conservative management of these injuries are presented in this review along with the authors' preferred technique for the anatomical repair of acute complete ruptures. Copyright © 2013 Elsevier Ltd. All rights reserved. DOI: 10.1016/j.injury.2013.01.003