Distal bicep tendon rupture is an uncommon form of bicep rupture which is typically seen in middle-aged men. We identified two cases in which the distal bicep tendon rupture was repaired with an EndoButton™ (Smith and Nephew, Watford, UK) and interference screw with preservation of the EndoButton™ but a failure of the interference screw. This report highlights the addition of a FiberWire ® (Arthrex, Inc., Naples, Florida, USA) construct to secure the interference screw from backing out and emphasizes the EndoButton™ as the primary biomechanical anchor in maintaining a successful distal bicep tendon repair. We question the necessity of both the interference screw and EndoButton™ in the fixation of the distal bicep tendon and recommend that securing the interference tenodesis screw with an additional FiberWire ® may provide a more secure fixation of the screw as compared to traditional approaches.
Symptomatic arthritis of the distal radioulnar joint (DRUJ) is often treated nonoperatively but with persistent symptoms may be treated surgically with partial or complete distal ulna resection. In many of these cases, ulna resection in combination with tendon reconstruction can successfully restore hand function. We identified three patients who underwent the Darrach procedure to treat DRUJ arthritis that developed attritional ruptures due to sharp prominent bone edges or dorsal capsule disruption. In addition to our recent three patients, an additional three isolated case reports, and two cases in a 29-patient series reported post-operative extensor tendon rupture as a complication after a Darrach procedure more than 30 years ago. While extensor tendon rupture is rarely reported in recent literature as a complication of distal ulna excision, surgeons may be able to minimize the risk of this complication intra-operatively by ensuring the resected distal ulnar stump is smooth, free of bony prominences, any capsular deficiencies are reconstructed, and that extensor tendons are able to glide freely.
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