Partial Tears of the Distal Biceps Brachii Tendon: A Systematic Review of Surgical Outcomes

Behun, Michael A.; Geeslin, Andrew G.; O’Hagan, Emma; King, Jeffrey C.

doi:10.1016/j.jhsa.2016.04.019

Cited by 38 publications

(20 citation statements)

References 34 publications

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“…A complete tear of the distal biceps brachii tendon, while an uncommon injury, is readily diagnosed on the basis of history and physical examination. This injury has a well-described presentation of a traumatic event followed by pain in the antecubital fossa, pain and weakness with flexion and supination, and an abnormal hook test, as previously described in the literature (Nielsen, 1987;Bourne and Morrey, 1991;Rokito et al, 1996;D€ urr et al, 2000;Vardakas et al, 2001;Kelly et al, 2003;Dellaero and Mallon, 2006;Frazier et al, 2010;Behun et al, 2016). Partial tears, on the other hand, are rarely discussed in the literature and present a diagnostic challenge.…”

Section: Discussionmentioning

confidence: 78%

“…Misdiagnosis of partial tears can lead to mismanagement of these injuries. Earlier studies revealed that surgical treatment resulted in satisfactory outcomes and low complication profiles, so it was a viable option for patients who had failed conservative therapy (Bourne and Morrey, 1991;Rokito et al, 1996;Vardakas et al, 2001;Kelly et al, 2003;Dellaero and Mallon, 2006;Frazier et al, 2010;Behun et al, 2016). Accurate diagnosis is crucial for indicating these refractory cases for surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Partial tears of the distal biceps brachii tendon are uncommon and have mostly been described in small case series or case reports (Nielsen, 1987;Bourne and Morrey, 1991;Rokito et al, 1996;D € urr et al, 2000;Vardakas et al, 2001;Kelly et al, 2003;Dellaero and Mallon, 2006;Frazier et al, 2010;Behun et al, 2016). The lack of traumatic or inciting event could partly account for the rarity of this diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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A novel clinical test for partial tears of the distal biceps brachii tendon: The TILT sign

Shim

Strauch

2018

Clinical Anatomy

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Partial tears of the distal biceps brachii tendon are rare. A complete tear of the distal biceps brachii tendon is readily diagnosed on the basis of history and physical examination and has a well-described clinical presentation of acute pain in the antecubital fossa, localized tenderness, swelling, palpable defect, positive hook test, and weakness in forearm supination and elbow flexion. Partial tears, on the other hand, can present more subtly and remain a diagnostic challenge. We present a novel physical examination technique that utilizes the rotational anatomy of the radius. The patient's forearm is passively supinated and pronated with the elbow flexed to 90° while the examiner firmly palpates the dorsal forearm overlying the radial tuberosity. The tuberosity presents itself beneath the examining fingers only in full forearm pronation. A positive test is indicated by tenderness over the radial (or lateral) aspect of the tuberosity (TILT sign) only in full forearm pronation, and not in supination. We have found this diagnostic test to be 100% sensitive for diagnosing partial distal biceps brachii tendon tears over the last five years during which it has been in use. Representative example cases are presented. A positive TILT sign indicates a diagnosis of partial tear of the distal biceps brachii tendon. This simple diagnostic maneuver could facilitate earlier detection of these injuries. Clin. Anat. 31:301-303, 2018. © 2017 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A novel clinical test for partial tears of the distal biceps brachii tendon: The TILT sign

Shim

Strauch

2018

Clinical Anatomy

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“…Other complications, such as injury to the interosseus posterior nerve (PIN), heterotopic ossifications, and radioulnar synostoses, are possible. Heterotopic ossifications occur less commonly with the above mentioned “single incision” technique compared to the “double incision” technique (7%), but are often clinically irrelevant ( 17 ) .…”

Section: Treatment Optionsmentioning

confidence: 99%

Ultrasound of the elbow with emphasis on the sonoanatomy of the distal biceps tendon and its importance for the surgical treatment of tendon lesions

et al. 2020

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Degenerative or traumatic ruptures of the distal biceps tendon are less common than proximal lesions. Distal lesions lead to a significant loss of function with usually considerable discomfort for patients. Therefore, precise diagnostics using operator-dependent high-resolution musculoskeletal ultrasound with illustration of the extent of the affected tendon lesion are important for optimizing patient management. In this article, we discuss the precise high-resolution musculoskeletal ultrasound and sonoanatomy of the distal biceps tendon and emphasize its importance for the surgical treatment of tendon lesions. In this review and pictorial essay, we first focus on the description of the precise anatomy and ultrasound anatomy of this clinically important region. Furthermore, we highlight different ultrasound scanning techniques for the correct assessment of the distal biceps tendon. Various approaches for optimal sonographic assessment of the distal biceps tendon have been suggested in the literature: the anterior approach, the lateral access, the medial access and the posterior approach. In the second part of the article, we focus on the evaluation of surgical repair techniques of distal biceps tendon lesions considering the extent of the rupture zone of the distal biceps tendon based on the ultrasound findings. Surgical techniques are explained from the orthopedic surgical point of view.

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“…Distal biceps tendinopathy should be understood not as a single disease but as a spectrum of disease encompassing a group of disorders classified according to the site and severity of the lesion, such as bicipitoradial bursitis, distal biceps chronic tendon degeneration, distal biceps partial tear, and distal biceps complete tear [ 2 , 3 ]. The cases of complete tear of the distal biceps tendon are reported to account for 3% of the total cases of biceps tendon ruptures, and the prevalence of this disease is known to be 2.55 per 100,000 population [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

A Case Series of Symptomatic Distal Biceps Tendinopathy

Lee

Kim

Lee

et al. 2018

Clin Shoulder Elbow

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BACKGROUND: The study of conservative and surgical treatment of distal biceps tendinopathy and associated biceps tendon partial rupture.METHODS: Twenty-one cases with distal biceps tendonitis and partial ruptures were studied who visited Pohang Semyeong Christianity Hospital from June 2010 to August 2017. The mean age was 57.1 years (39?69 years), 14 males and 7 females. The mean duration of symptom at the time of first visit was 4.9 months (0.2?14 months). Ultrasonography and magnetic resonance imaging were performed for patients with severe symptoms. According to the severity of the symptoms, splint immobilization, oral nonsteroidal anti-inflammatory drugs, and ultrasound-guided steroid injection were performed. Surgical treatment was performed if the patient did not respond to conservative treatment for 3 to 6 months or longer.RESULTS: There were 9 cases of partial rupture of the distal biceps tendon associated with distal biceps tendinopathy on imaging studies. Conservative treatment showed symptomatic improvement in 16 of 21 cases. In 4 cases with a relatively mild symptom, anti-inflammatory analgesics and intermittent splinting showed good result. In 12 cases, symptoms improved after ultrasonography-guided steroid injection. Surgical treatment was performed on 5 cases that did not respond to conservative treatment.CONCLUSIONS: Conservative treatment of distal biceps tendinopathy may promise good results. However, in case of partial tear of the distal biceps tendon and refractory to conservative treatment, surgical treatment may be needed.

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Partial Tears of the Distal Biceps Brachii Tendon: A Systematic Review of Surgical Outcomes

Cited by 38 publications

References 34 publications

A novel clinical test for partial tears of the distal biceps brachii tendon: The TILT sign

A novel clinical test for partial tears of the distal biceps brachii tendon: The TILT sign

Ultrasound of the elbow with emphasis on the sonoanatomy of the distal biceps tendon and its importance for the surgical treatment of tendon lesions

A Case Series of Symptomatic Distal Biceps Tendinopathy

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