Distal Biceps Tendon Injuries: Diagnosis and Management

Ramsey, Matthew L.

doi:10.5435/00124635-199905000-00006

Cited by 174 publications

(119 citation statements)

References 28 publications

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“…Once believed to be rare, studies during the last several decades have suggested an increase in the number of cases of distal biceps tendon ruptures, and a decrease in the age of those injured [1,2,6,16,19]. Unlike other tendon ruptures, which can occur intrasubstance or at the musculotendinous junction, a complete distal biceps tendon rupture almost always occurs at the tendon's insertion to the radial tuberosity.…”

Section: Introductionmentioning

confidence: 99%

“…Unlike other tendon ruptures, which can occur intrasubstance or at the musculotendinous junction, a complete distal biceps tendon rupture almost always occurs at the tendon's insertion to the radial tuberosity. The functional superiority of anatomic surgical repair for this injury is now well established and has gained acceptance as the preferred treatment option for restoring strength in supination and flexion [2,5,12,13,14,16]. If surgical treatment of a complete distal biceps tendon rupture is delayed, a combination of muscle retraction, adhesion formation, distal tendon shortening, and degeneration can make anatomic reinsertion of the original tendon difficult [14,16,22].…”

Section: Introductionmentioning

confidence: 99%

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The Biceps Crease Interval for Diagnosing Complete Distal Biceps Tendon Ruptures

Elmaraghy

Devereaux

Tsoi

2008

Clin Orthop Relat Res

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Complete distal biceps tendon ruptures require prompt surgical management for optimal functional and aesthetic outcome. The need exists for a valid and reliable diagnostic tool to expedite surgical referral. We hypothesized complete distal biceps tendon ruptures result in an objectively measurable anatomic landmark (the distance between the antecubital crease of the elbow and the cusp of distal descent of the biceps muscle, or the biceps crease interval), as a result of proximal retraction of the musculotendinous complex. We established normal biceps crease interval values and biceps crease ratios between dominant and nondominant arms in 80 men with no history of biceps injury (average age, 43 years). The mean (± standard deviation) biceps crease interval for dominant and nondominant arms was 4.8 ± 0.6 cm. The mean biceps crease ratio was 1.0 ± 0.1. We measured the biceps crease interval and biceps crease ratio on 29 consecutive patients presenting with a possible complete distal biceps tendon rupture. Using a diagnostic threshold of a biceps crease interval greater than 6.0 cm or biceps crease ratio greater than 1.2, the biceps crease interval test had a sensitivity of 96% and a diagnostic accuracy of 93% for identifying complete distal biceps tendon ruptures, making it a valid and reliable tool for clinicians to identify cases requiring urgent surgical referral.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Biceps Crease Interval for Diagnosing Complete Distal Biceps Tendon Ruptures

Elmaraghy

Devereaux

Tsoi

2008

Clin Orthop Relat Res

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“…The disadvantage of this operation is that the supination function of the biceps is not restored. Others have recommended nonoperative management, arguing that elbow flexion still occurs with adequate strength through the brachialis muscle and that shoulder adduction along with internal rotation augments supination [3,18]. Modern series suggest, however, that repair should be undertaken in active and healthy patients to achieve the optimum functional results [1,5,12,14,17].…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Posterior Interosseous Nerve Injury following Biceps Tendon Repair: Case Report and Cadaveric Study

Mokhtee

Brown

Mackinnon

et al. 2008

Hand (New York, N,Y.)

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Surgical repair of distal biceps tendon rupture is a technically challenging procedure that has the potential for devastating and permanently disabling complications. We report two cases of posterior interosseous nerve (PIN) injury following successful biceps tendon repair utilizing both the single-incision and two-incision approaches. We also describe our technique of posterior interosseous nerve repair using a medial antebrachial cutaneous nerve graft (MABC) and a new approach to the terminal branches of the posterior interosseous nerve that makes this reconstruction possible. Finally, we advocate consideration for identification of the posterior interosseous nerve prior to reattachment of the biceps tendon to the radial tuberosity.

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“…3 Especially in cases where the lacertus fibrosis is also ruptured, the distal biceps tendon retracts proximally after injury. In chronic distal biceps ruptures, the combination of muscle atrophy and shortening, distal tendon retraction, and fibrosis makes primary anatomic reattachment of the tendon challenging (Table 1).…”

mentioning

confidence: 99%

“…This sudden overpowering force results in an acute avulsion of the distal tendon stump from the bicipital tuberosity. 2,3 Most often, distal bicep ruptures occur in the dominant arm (86%) of males between the ages of 30 and 50 years 4 with a history of tobacco use as a significant risk factor. 1,5 Despite its low annual incidence, distal biceps ruptures can lead to significant patient morbidity.…”

mentioning

confidence: 99%

Chronic Distal Biceps Repair With an Achilles Allograft

Ding

Ryan

Strauss

et al. 2016

Arthroscopy Techniques

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In cases of chronic distal biceps ruptures, the combination of muscle atrophy, distal tendon retraction, and fibrosis makes primary anatomic reattachment of the tendon particularly challenging. To regain tendon length and avoid flexion contractures, reconstruction with graft augmentation has been proposed as an alternative for cases not amenable to primary repair. We describe our technique using an Achilles allograft through a modified Henry approach to reconstruct the distal biceps tendon to regain length as well as restore flexion and supination strength. With proper and detailed exposure, chronic distal biceps injuries can be reconstructed safely and efficaciously using an Achilles allograft.

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Distal Biceps Tendon Injuries: Diagnosis and Management

Cited by 174 publications

References 28 publications

The Biceps Crease Interval for Diagnosing Complete Distal Biceps Tendon Ruptures

The Biceps Crease Interval for Diagnosing Complete Distal Biceps Tendon Ruptures

Reconstruction of Posterior Interosseous Nerve Injury following Biceps Tendon Repair: Case Report and Cadaveric Study

Chronic Distal Biceps Repair With an Achilles Allograft

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