Repair of Distal Biceps Tendon Ruptures Using a Suture Anchor and an Anterior Approach

Abstract

In a prospective study, eight consecutive patients with nine ruptures of the distal biceps tendon underwent repair through a single incision. All patients were satisfied with their clinical results and had full ranges of elbow and forearm motion. There were no radial nerve injuries and no radio-ulnar synostoses. Isokinetic testing, after correction for dominance, demonstrated a 6% strength deficit, but 7% higher endurance in the repaired extremity for the flexion-concentric test, and no strength deficit and 13% higher endurance for supination. The improved endurance is probably explained by initial reduced effort due to apprehension which minimized subsequent fatigue.

A Simple Grafting Method to Repair Irreparable Distal Biceps Tendon

“…If a free graft is used, we still recommend immobilization for 5 to 6 weeks. Isokinetic testing after acute distal biceps tendon repair showed good recovery of strength and endurance in the repaired extremity for flexion-concentric testing and supination [4]. However, at 1 year followup after the Boyd-Anderson technique, the elbow flexion strength was reduced by 13% and supination strength by 19% [17].…”

Lesão do bíceps distal: avaliação funcional e dinamometria digital da sua reconstrução pela técnica da minidupla via de mayo

“…This suggests that surgical repair might be more indicated for athletes, patients with high functional demands and patients who do not accept loss of strength or esthetic deformity (1,4,7) . Surgical repair may attain a muscle strength level similar to that of the unaffected contralateral limb (2,3,6,(8)(9)(10)(11)(12)20) . Studies on surgical treatment have demonstrated high levels of muscle strength and resistance for the elbow flexors and forearm supinators after surgical repair (2,3,6,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)20) .…”

“…The first technique described was lesion repair by means of a single anterior incision. However, reports in the literature have demonstrated complications such as injury to the radial artery, median nerve and posterior interosseous nerve (6,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(19)(20)(21) . In 1961, Boyd and Anderson (3) introduced a double-incision technique in order to minimize these risks.…”

“…Elbow flexion is optimized through supination, and the maximum torque with the elbow is at flexion of between 90 o and 110º (2)(3)(4) . The injury mechanism is usually traumatic, and injury occurs when an eccentric load of 400 newtons or more is applied to the forearm with the elbow at 90°( [4][5][6] . Tendons with degenerative characteristics secondary to bursopathy and conditions that affect collagen metabolism may also be factors predisposing towards this type of lesion (2,(7)(8)(9)(10)(11) .…”

“…Tendons with degenerative characteristics secondary to bursopathy and conditions that affect collagen metabolism may also be factors predisposing towards this type of lesion (2,(7)(8)(9)(10)(11) . The clinical condition comprises sudden acute pain in the region of the cubital fossa that persists for a few hours, followed by a less intense pain that may When proximal retraction occurs, use of grafts is indicated in order to perform tenodesis (6,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(19)(20)(21) . The grafts used generally come from the fascia lata, radial flexor of the carpus, semitendinosus or calcaneal tendon (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(19)(20)(21) .…”