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肱二头肌远端腱修复术

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Distal biceps rupture repair — restoring elbow flexion strength and addressing the “Popeye” deformity.

Updated Aug 2026
一幅手绘插图,描绘了一个无面的人正在用力举起东西,在肘部前方肱二头肌腱附着处有疼痛感。
远端肱二头肌肌腱撕裂的MRI影像:肌腱(箭头所示)已从桡骨粗隆处回缩。修复术将其重新锚定于骨面上。 Kieran Hirpara 4.0

本页面由机器翻译,尚未经临床医生审核。英文版本为权威版本。

为何建议进行此手术

本页面反映了罗克汉普顿 Mater 私人医院上肢外科医生 Kieran Hirpara 医生在门诊中的诊疗思路。我们提供肱二头肌远端腱修复术,该手术旨在将您的肱二头肌腱重新连接至前臂骨。患者由全科医生(GP)或物理治疗师转诊至我们的门诊。门诊评估用于确立诊断。对于急性撕裂,我们可能会建议立即进行手术。对于退行性问题,我们通常首先尝试非手术治疗。当非手术治疗未能带来足够改善时,我们会考虑手术。

手术通常用于完全性撕裂,以恢复力量和功能。如果您存在完全性撕裂,您的外科医生可能会建议进行此手术。手术治疗可改善此类患者的预后。大多数患者在修复术后能够重返工作和运动。每 20 名患者中约有 1 名在肱二头肌远端腱手术后会出现轻微并发症。每 20 名患者中约有 1 名在肱二头肌远端腱手术后会出现严重并发症。我们的目标是恢复您手臂的力量和稳定性。这有助于您自信地回归日常活动和体育运动。

手术前

您必须在手术前禁食六小时。请按照外科医生的指示停用某些抗凝药物和补充剂。安排他人接送回家,并携带您当前用药清单。穿着宽松舒适的衣物。您可能需要进行X光或MRI检查以评估肘关节。血液检查和麻醉评估确保您适合手术。您的外科医生将通过肘前部的单个切口进行修复。这种开放入路可直接到达肌腱。我们将在术前评估期间与您讨论任何特定的药物调整。

手术当天

本手术在全身麻醉下进行。手术期间您将完全处于睡眠状态。部分患者可能还会接受区域神经阻滞以缓解术后疼痛——麻醉医生将根据您的具体情况在手术当天决定。

您将抵达医院,并在进入手术室前与您的外科医生见面。您的外科医生将通过肘前部的一道切口进行此修复手术。这种开放入路可直接到达肌腱。手术完成后,您将在复苏室苏醒。我们将监测您的舒适度并检查您的手臂。根据您自身的感觉,您当天即可出院,或需短暂住院观察。

手术过程

您的外科医生将在肘部前方做一个切口,以到达断裂的二头肌肌腱。这种开放入路可直接到达损伤部位。随后,外科医生会将断裂的肌腱重新固定回其解剖位置,以恢复肌肉的连接,使其功能恢复正常。

为了将肌腱固定在位,您的外科医生会使用一种植入骨内的小型锚定装置。该方法可为愈合提供牢固的固定。随后,切口将通过缝合或钉合进行闭合,并敷上敷料以保护该区域。

该手术通常通过单一切口进行开放手术。其重点在于恢复肘部的解剖结构,以改善力量和功能。

术后

您将在复苏室苏醒,手臂佩戴简易吊带。大多数患者术后需住院一晚,但部分患者可于同日出院。我们将通过无菌敷料管理您的疼痛并护理伤口。术后24小时内必须有人陪护。本手术采用经前侧单一切口的开放入路。您需要佩戴吊带约六周——为简易吊带,而非带铰链的肘部支具。只要仍需佩戴吊带,无论哪侧手臂,均不得驾驶。患者通常在拆除吊带后的六周时恢复驾驶。详见上肢手术后驾驶

恢复

术后前几天,您可能会经历一些疼痛和肿胀。这是身体愈合过程中的正常现象。我们将为您提供在家管理不适的建议。抬高患肢有助于减轻肿胀。您将佩戴一个简单的吊带(而非带铰链的肘部支具)约六周,以保护修复部位。在需要佩戴吊带期间,无论手术哪一侧,均不得驾驶。通常,在移除吊带且您的外科医生允许后,您可以恢复驾驶。了解更多关于上肢手术后的驾驶信息

在手臂佩戴吊带期间,您的日常生活将发生变化。您需要适应穿衣、进食和睡眠的方式。我们建议您仰卧或向未手术侧侧卧,并支撑好患肢。您的物理治疗师将指导您进行轻柔的练习,以保持手和手指的活动。这有助于在肱二头肌肌腱愈合期间防止僵硬。

随着肿胀消退和活动度恢复,我们将逐步增加您的活动量。您的康复由 Extend Rehabilitation 的 Ruby Doolan 指导。她将帮助您在安全的前提下恢复力量和灵活性。您的恢复时间表可能与他人不同;您的外科医生和物理治疗师将根据您身体的反应为您提供指导。大多数患者发现,遵循这些步骤后,他们的力量和功能会稳步改善。

可能出现的问题

大多数患者恢复良好,但偶尔也会出现一些问题。您的外科医生和医疗团队会密切监测您的情况,以便尽早发现任何异常。

神经刺激是已知的风险。您可能会在前臂或手部感到刺痛、麻木或烧灼感。这是因为小神经位于手术部位附近。在大多数情况下,随着该区域愈合,这些感觉会逐渐消失。如果感觉严重或没有改善,请告知我们。

有时,不该长骨头的地方会长出额外的骨头。这称为异位骨化。您可能会在肘部附近的皮肤下摸到一个硬块。这可能会使弯曲手臂时感到僵硬或受限。然而,这种额外的骨头很少会影响您恢复力量。如果您发现新的硬块或明显的僵硬,请在随访时提及。

感染是一种严重但不常见的风险。您可能会看到切口周围出现扩散的红斑。该区域触摸时可能发热,或肿胀程度超出预期。您还可能出现发烧或发冷。如果您注意到这些迹象,请立即联系我们的诊所。早期治疗是快速解决问题的关键。

极少需要再次手术,但这仍是一种可能性。您可能会经历突然肿胀、药物无法缓解的剧烈疼痛,或感觉手臂无力。这些迹象可能表明修复出现问题。如果发生这种情况,请立即寻求医疗帮助,以便我们评估情况。

本页面底部的并发症表格列出了典型的发生率,如果您想了解具体数据,可参考该表格。

何时联系我们

如果您出现发热、伤口红肿加重或渗出,或突发剧烈疼痛,请立即联系我们。若发现小腿肿胀或呼吸困难,请前往急诊。若手部感觉丧失或肢体无法活动,请立即联系我们。我们希望确保您的康复进程顺利,并及时处理任何问题。


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