Cadaveric study of anterior and posterior elbow endoscopy portals for endoscopic distal biceps repair: comparative anatomy-at-risk

Abstract

Portals 1 (parabiceps portal) and 5 (distal posterior) can be safely placed for endoscopic access to the DBT. Portal 4 (open distal anterior) may be used after careful open dissection and under direct vision. Portals 2 and 3 are not recommended for elbow endoscopy.

Acute complete and partial distal biceps tendon ruptures: what have we learned? A review

“…Recent articles seem to confirm the safety of biceps endoscopy and showed the feasibility through a single anterior incision. 69 , 70…”

All-Endoscopic Management of Partial Tears of Distal Biceps Tendon

“…Similarly, the procedure should be avoided in patients with vascular anomalies and malunited fractures. Familiarity with the anatomical course of major neurovascular structures and their dynamic relationship to DBT is necessary to prevent any iatrogenic complications [3][4][5].…”

Distal Biceps Anatomy: Structural Morphometry and Dynamic Relationships

“…Bhatia et al evaluated five potential portal sites above and below the elbow crease for elbow endoscopy [7]. The study showed that the anterior portal placed above the elbow crease (parabiceps portal) was safe, while the three anterior portals placed at different levels below the elbow crease were significantly closer to neurovascular structures.…”

“…Familiarity with the morphometric anatomy and relationships of DBT with surrounding structures is crucial for optimal outcomes after open or endoscopic surgery for biceps pathology. The insertional anatomy of DBT and its dynamic relationship to the proximal radioulnar space and neurovascular structures have been quantified in recent studies, and this knowledge is crucial to understand safe placement of portals and incisions for open/endoscopic reconstruction techniques [1][2][3][4][5][6][7][8].…”