Cadaveric Study of Insertional Anatomy of Distal Biceps Tendon and its Relationship to the Dynamic Proximal Radioulnar Space

Bhatia, Deepak N.; Kandhari, Vikram; DasGupta, Bibhas

doi:10.1016/j.jhsa.2016.11.004

Cited by 44 publications

(35 citation statements)

References 27 publications

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“…In the largest series with 50 cadavers, Joshi found an average tendon length of 7.6cm and no side difference [ 14 ]. But he did not distinguish between sex and body size, as almost all other anatomical studies [ 12 , 13 , 15 ]. Only Shastry et al differentiated between 10 female and 14 male cadavers [ 16 ].…”

Section: Discussionmentioning

confidence: 96%

Indirect markers for length adjustment in distal biceps tendon allograft reconstruction

et al. 2021

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Chronic musculotendinous retraction, shortening and fibrosis after distal biceps tendon tears makes a primary reconstruction often difficult or even impossible. Interposition reconstruction with allograft provides a solution, however there is no consensus about appropriate intraoperative graft length adjustment. Therefore, the purpose of this study was to find a practical reference value for distal biceps tendon length adjustment. Three-dimensional surface models of healthy distal biceps tendons were created based on 85 MRI scans. The tendon length was measured from the myotendinous junction to the insertion on the bicipital tuberosity. Inter-epicondylar distance (IED) and radial head diameter (RHD) were measured on antero-posterior radiographs as a surrogate for patient size. Correlations between the tendon length and IED, RHD and patient’s height (PH) were calculated. Mean length of the external part of the distal biceps tendon was 69mm (female 64mm, male 71mm). The tendon length in mm was on average 1.1 times of the IED (mm), 3 times of the RHD (mm) and 0.4 times of PH (cm). Herewith, the tendon length could be predicted within a narrow range of +/-1cm in 84% by using IED, 82% by using RHD and 80% by using PH. Intra- and inter-reader reliabililty of IED and RHD was excellent (R2 = 0.938–0.981). The distal biceps tendon length can be best predicted within 1cm with an accuracy of 82–84% using the IED and RHD with an excellent intra- and inter-reader reliability.

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Section: Discussionmentioning

confidence: 96%

Indirect markers for length adjustment in distal biceps tendon allograft reconstruction

et al. 2021

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“…A clear understanding of these anatomic variations and its relationship with radial tuberosity is vital in planning and performing a distal biceps tendon repair and also in determining if a graft is required to supplement or replace the native tendon. There are studies done previously which describe the gross morphological anatomy of the distal biceps with main focus on distal footprint types and characteristics (7,8). But these studies do not give the normal morphometric measurements of the tendon.…”

Section: Discussionmentioning

confidence: 99%

Morphometric Profile of Distal Biceps Tendon: A Cadaveric Approach

Kumar

Shetty

Rao

2020

Muscle Ligaments and Tendons J

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Background. The biceps muscle has proximal tendons that attach the muscle to the shoulder and one distal tendon that attaches at the elbow, called the distal biceps tendon. Normal morphometric measurements of the distal biceps tendon serve as an important landmark in restoring its biomechanical characteristics and anthropometric evaluation during surgical tendon repairs. Hence the objective of this study was to provide a detailed morphometric profile of the distal biceps tendon. Methods. A total of 50 dissected adult limbs were studied. Out of the 50 limbs, 25 belonged to the right side while 25 were of the left side. The insertion pattern of the distal tendon was dissected and recorded. Total length, post aponeurotic length, the proximal, and distal thickness of the tendon was measured. Results were tabulated and correlated using SPSS. Results. The mean length of the tendon was 8 cm. The proximal thickness varied from 2 to 4 cm, distal thickness from 1 to 3 cm. Tendon length and thickness showed no statistically significant differences between the right and left sides. However, significant correlation (p < 0.001) was observed between length and thickness, proximal and distal thickness of the tendon. Conclusions. The variation in length, width of distal biceps footprints and radial tuberosities may be significant in the anatomical restoration of the distal biceps tendon. This morphometric study of distal biceps tendon would be beneficial to sports medicine physicians for diagnosis and treatment of biceps tendon tear and tendinopathy.

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“…4 The importance of the radio-ulnar space has also been demonstrated by the study by Bhatia that demonstrated that the spaced reduces significantly from the fully supinated to the fully pronated position. 5 This elliptic form also has its consequence of the humero-radial joint. From biomechanical point of view, it has been described that different orientations of the longest axis of the noncircular radial head will result in different forces in the humero-radial joint.…”

Section: Discussionmentioning

confidence: 99%

Positioning of longest axis of the radial head in neutral forearm rotation

et al. 2019

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Introduction The radial head has an ellipsoid shape so that a longest and a shortest axis can be defined. The aim of this study is to evaluate the position of the longest axis of the radial head (LARH) in relation to proximal radioulnar joint (PRUJ) and to the forearm in neutral position using 3D computed tomography (CT). Materials and methods 3D CT reconstructions of the distal humerus, the radius and the ulna of 27 healthy volunteers (average age 27.65 ± 9.25; 24 males, 3 females) were created. First an evaluation of the elliptic form of the radial head and the location of its longest axis was performed. Next, three planes were defined: the PRUJ plane, the forearm plane and a neutral plane. Based on the angle between the forearm plane and the neutral plane, the rotation of the scanned forearm was measured. Taking this rotation into account, the position of the LARH compared to PRUJ plane and forearm plane in neutral position is recalculated. Results The shape of the radial head is determined to be non-circular based on this study population (p < .001). In neutral position, the angle between the LARH and the forearm plane is 5.28° (SD: 15.09) and between the LARH and the PRUJ is 33.46° (SD: 13.91). Conclusions The position of the LARH is found to be approximately perpendicular to the forearm plane when the forearm is in neutral position and perpendicular to the PRUJ plane when the forearm is on average in 30° of pronation.

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Cadaveric Study of Insertional Anatomy of Distal Biceps Tendon and its Relationship to the Dynamic Proximal Radioulnar Space

Abstract: Postoperative DBT impingement in the RUS may be prevented by avoiding techniques that increase the thickness of the tendon and by using a reattachment site at the proximal aspect of the tuberosity.

Cited by 44 publications

References 27 publications

Indirect markers for length adjustment in distal biceps tendon allograft reconstruction

Indirect markers for length adjustment in distal biceps tendon allograft reconstruction

Morphometric Profile of Distal Biceps Tendon: A Cadaveric Approach

Positioning of longest axis of the radial head in neutral forearm rotation

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