Supination torque following single- versus double-incision repair of acute distal biceps tendon ruptures

Stockton, David J.; Tobias, Gabriel; Pike, Jeffrey M.; Daneshvar, Parham; Goetz, Thomas J.

doi:10.1016/j.jse.2019.07.041

Cited by 12 publications

(15 citation statements)

References 27 publications

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“… 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 The rupture can result in the weakness of arm flexion and supination. 1 , 2 , 3 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 The restoration of functional strength following a biceps tendon rupture is possible with surgical intervention and has largely been shown to be a direct function of reattachment position relative to anatomic footprints. 2 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 15 , 17 , 18 , 19 , 21 Achieving full supination from a partially supinated orientation, an action potentially clinically relevant for the performance of activities such as using a screwdriver, has been shown to be particularly strongly related to tendon reattachment position.…”

mentioning

confidence: 99%

“…Many approaches, including single-incision anterior and double-incision posterior techniques, with various fixation methods have been described to accomplish tendon reattachment to the radial tuberosity. 1 , 2 , 3 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 18 , 19 , 20 , 21 , 22 Although both single-incision anterior and double-incision posterior techniques have shown significant repair success, each is associated with operative difficulties and postoperative complications that negatively impact the quality of the repair. 1 , 2 , 7 , 8 , 9 , 10 , 12 , 13 , 14 , 17 , 18 , 19 , 20 , 21 , 22 Thus, to date, there has been no consensus on the best approach to the repair.…”

mentioning

confidence: 99%

“… 1 , 2 , 3 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 18 , 19 , 20 , 21 , 22 Although both single-incision anterior and double-incision posterior techniques have shown significant repair success, each is associated with operative difficulties and postoperative complications that negatively impact the quality of the repair. 1 , 2 , 7 , 8 , 9 , 10 , 12 , 13 , 14 , 17 , 18 , 19 , 20 , 21 , 22 Thus, to date, there has been no consensus on the best approach to the repair. 1 , 2 , 3 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 20 The double-incision posterior technique consistently allows exposure for true anatomic footprint reattachment, but the extensor carpi ulnaris and, importantly, the supinator must be split to do so, potentially resulting in functionally significant decreases in the supination torque.…”

mentioning

confidence: 99%

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Power-Optimizing Repair for Distal Biceps Tendon Rupture: Stronger and Safer

Tadevich

Bhagat

Lim

et al. 2021

Journal of Hand Surgery Global Online

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Purpose: Many approaches have been described to accomplish tendon reattachment to the radial tuberosity in a distal biceps tendon rupture, with significant success, but each is associated with potential postoperative complications, including posterior interosseous nerve (PIN) injury. To date, there has been no consensus on the best approach to the repair. The purpose of this study was to evaluate the supination strength and the distance of drill exit points from the PIN in a power-optimizing distal biceps repair method and compare the findings with those of a traditional anterior approach endobutton repair method. Methods: Cadaveric arms were dissected to allow for distal biceps tendon excision from its anatomic footprint. Each arm was repaired twice, first with the power-optimizing repair using an anterior singleincision approach with an ulnar drilling angle and biceps tendon radial tuberosity wraparound anatomic footprint attachment, then with the traditional anterior endobutton repair. Following each repair, the arm was mounted on a custom-built testing apparatus, and the supination torque was measured from 3 orientations. The PIN was then located posteriorly, and its distance from each repair exit hole was measured. Results: Five cadaveric arms, each with both the repairs, were included in the study. On average, the power-optimizing repair generated an 82%, 22%, and 13% greater supination torque than the traditional anterior endobutton repair in 45 supination, neutral, and 45 pronation orientations, respectively. On average, the power-optimizing repair produced drill hole exit points farther from the PIN (23 mm) than the traditional anterior endobutton repair (14 mm). Conclusions: The power-optimizing repair provides a significantly greater supination torque and produces a drill hole exit point significantly farther from the PIN than the traditional anterior endobutton approach.Type of study/level of evidence: Therapeutic III.

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Power-Optimizing Repair for Distal Biceps Tendon Rupture: Stronger and Safer

Tadevich

Bhagat

Lim

et al. 2021

Journal of Hand Surgery Global Online

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“…Esta reparación quirúrgica tiene dos opciones de abordaje, una vía anterior única, donde el riesgo radica en lesionar el nervio interóseo posterior (NIOP) y una vía de abordaje doble, donde existe un riesgo aumentado de calcificaciones heterotópicas y sinostosis radio-cubital 10 . Esta doble vía parecía mejorar el déficit de supinación del abordaje anterior, pero estudios recientes 11 encuentran rangos de movilidad similares e incluso superiores con la vía anterior única. De la misma forma, la lesión del NIOP parece estar más relacionada con la técnica de reparación utilizada que con la vía de abordaje 12 , por lo que consideramos la vía única anterior como una opción de abordaje fiable en este tipo de lesiones.…”

Section: Discussionunclassified

Rotura aguda de bíceps distal: reparación mediante abordaje único anterior y dispositivo de anclaje cortical

Pinilla-Gracia

Hernández-Fernández

Rodríguez-Nogué

et al. 2021

Rev Fac Cien Med Univ Nac Cordoba

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Antecedentes: La rotura del tendón distal del bíceps braquial es una patología con una incidencia creciente, que puede ocasionar importantes alteraciones funcionales. Cuando la rotura es completa y el paciente activo, el tratamiento quirúrgico es de elección. Material y método: Varón de 47 años con dolor intenso y súbito en la fosa antecubital izquierda mientras levantaba peso. A la exploración, impotencia para la flexión y supinación activa del brazo izquierdo con pérdida de la silueta del bíceps braquial. La ecografía confirma el diagnóstico de rotura completa del tendón distal del bíceps braquial. Se decide tratamiento quirúrgico, realizando un abordaje único anterior y reinsertando el tendón en su “footprint” radial con ayuda de un dispositivo de anclaje cortical. Resultados: A los 12 meses, el paciente presenta flexo-extensión y prono-supinación completa, sin encontrar dificultades para realizar las actividades de su vida diaria y laboral, con puntación de 100 puntos en el Mayo Elbow Performance Score (MEPS). Conclusión: La rotura del bíceps distal es una lesión típica de pacientes activos con una incidencia creciente. Aunque no se han evidenciado diferencias significativas entre las distintas opciones de reparación, en nuestra experiencia la utilización de dispositivos de anclaje cortical con un abordaje único anterior aporta unos resultados muy satisfactorios.

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“…Surgeons must be mindful of the risks and benefits of single-versus double-incision exposures and anatomic-versus nonanatomic repairs. [8][9][10][11] The more common fixation techniques for distal bicep repairs include suspensory cortical button, bone tunnels, suture anchors, and intraosseous screw fixation, which have all proven to be effective options. 3,8,12 Despite the many techniques for distal biceps ruptures, there is no consensus on the ideal operative technique.…”

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confidence: 99%

Mini-Open Distal Biceps Tendon Repair Using All-Suture Anchors

Cross

Jildeh

Guo

et al. 2020

Arthroscopy Techniques

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Distal biceps tendon ruptures are uncommon injuries that can cause impairment in range of motion and function. While distal bicep tendon repair to the radial tuberosity has been demonstrated to restore function and strength, there is a lack of consensus on the optimal technique. The purpose of this Technical Note and video is to provide our preferred method of repair using an open, onlay-tissue fixation with all-suture anchors (FiberTak; Arthrex) and anatomic positioning of the biceps tendon on the radial tuberosity.

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Supination torque following single- versus double-incision repair of acute distal biceps tendon ruptures

Cited by 12 publications

References 27 publications

Power-Optimizing Repair for Distal Biceps Tendon Rupture: Stronger and Safer

Power-Optimizing Repair for Distal Biceps Tendon Rupture: Stronger and Safer

Rotura aguda de bíceps distal: reparación mediante abordaje único anterior y dispositivo de anclaje cortical

Mini-Open Distal Biceps Tendon Repair Using All-Suture Anchors

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