Distal Biceps Brachii Tendon Repairs

Shields, Edward; Olsen, Joshua R.; Williams, Richard; Rouse, Lucien; Maloney, Michael D.; Voloshin, Ilya

doi:10.1177/0363546515570465

Cited by 50 publications

(16 citation statements)

References 19 publications

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“…Several series have correlated the use of a single incision with higher complication rates, while multiple other studies have contradicted these findings. 2,8,10,11,13,15 Close examination of studies by Grewal et al, 8 Cain et al, 2 and Shields et al 13 shows that higher reported total complication rates with a single incision can be largely attributed to sensory neuropathies. 6 The frequency of less common major complications, including posterior interosseous nerve (PIN) palsy, symptomatic heterotopic ossification (HO), and proximal radioulnar synostosis, is not well documented because of the small size of reported series.…”

mentioning

confidence: 99%

Major complications after distal biceps tendon repairs: retrospective cohort analysis of 970 cases

Ford

Andersen

Macknet

et al. 2018

Journal of Shoulder and Elbow Surgery

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mentioning

confidence: 99%

Major complications after distal biceps tendon repairs: retrospective cohort analysis of 970 cases

Ford

Andersen

Macknet

et al. 2018

Journal of Shoulder and Elbow Surgery

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“… 1 , 16 , 22 , 23 Cortical button fixation has been shown to outperform bone tunnels, intraosseous screws, and suture anchors in biomechanical studies. 7 , 12 , 16 , 19 As noted previously, the most common major complication following surgery is PIN palsy, and unicortical button fixation may have the advantage of avoiding inadvertent injury to the PIN. 13 While these biomechanical studies were most demonstrative of time-zero construct strength and stability, there is minimal evidence evaluating techniques under cyclic loading conditions.…”

Section: Discussionmentioning

confidence: 88%

“… 5 , 6 , 7 , 8 Complications associated with primary anatomic repair include heterotopic ossification, radioulnar synostosis or loss of forearm rotation, lateral antebrachial cutaneous nerve or posterior interosseous nerve (PIN) palsy, and bicipital tuberosity fracture. 4 , 9 , 10 , 11 , 12 In a recent systematic review evaluating complications following distal biceps tendon repair, the authors noted that the most common major complication was PIN palsy (1.6%), followed by re-rupture (1.4%) and symptomatic heterotopic ossification (0.3%). 13 Bain et al.…”

mentioning

confidence: 99%

No Significant Difference Between Intramedullary and Extramedullary Button Fixation for Distal Biceps Brachii Tendon Rupture After Cyclic Loading in a Cadaver Model

Majumdar

Salas

Chavez

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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To biomechanically compare intramedullary (IM) versus extramedullary (EM) distal biceps button fixation under cyclic loading conditions, which is most representative of postoperative physiologic status. Methods: This controlled laboratory study used 13 fresh-frozen matched paired cadaver elbows. One specimen from each pair was randomized to either IM (unicortical) or EM (bicortical) distal biceps button fixation via onlay technique. A servohydraulic actuator was used to cycle each specimen from full extension to 90 of flexion at 0.5 Hz for 3,000 cycles. All specimens were subsequently loaded to failure to simulate an acute postoperative load. Results: During cyclic loading, the mean change in force from cycle 5 to cycle 3000 was 2.1 AE 3.2 N for the IM group and 0.6 AE 4.2 N for the EM group (P ¼ .19). The increase in tendon gap for the IM group was 1.02 mm and for the EM group was 1.83 mm (P ¼ .37). During failure loading, the IM group had a mean failure load of 154.9 AE 44.5 N and the EM group a mean failure load of 191.1 AE 62.6 N (P ¼ .16). Conclusions: No significant differences exist between the IM and EM techniques in loss of force and tendon gap formation under cyclic loading or load to failure conditions. Thus, IM fixation may adequately facilitate optimal bonetendon apposition, with less risk of iatrogenic injury to the posterior interosseous nerve that can be seen with bicortical extramedullary fixation. Clinical Relevance: The most common major complication following distal biceps repair is PIN palsy. IM fixation may be sufficient in facilitating optimal bone-tendon apposition and healing with onlay technique, while minimizing risk of iatrogenic PIN injury associated with EM fixation.

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“…26 Single-incision cortical button demonstrated more complications (30%) compared to double-incision bone tunnel suture fixation (4.8%), mostly consistent with permanent superficial radial nerve paresthesias. 27 Overall, both techniques provided good clinical results.…”

Section: Treatment Of Tendon Tearsmentioning

confidence: 84%

Distal biceps tendon injuries

2016

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Distal biceps tendon (DBT) conditions comprise a spectrum of disorders including bicipitoradial bursitis, partial tears, acute and chronic complete tears.In low-demand patients with complete DBT tears, non-operative treatment may be entertained provided the patient understands the potential for residual weakness, particularly in forearm supination.Most acute tears are best treated by primary repair using either single-incision or double-incision techniques with good clinical outcomes.Single-incision techniques may carry a higher risk of nerve-related complications, whereas double-incision techniques have historically been considered to carry a higher risk of heterotopic ossification, particularly if the ulna is exposed.Various fixation techniques, including bone tunnels, cortical buttons, suture anchors, interference screws or a combination seem to provide different fixation strength but similar clinical outcomes.Some chronic tears may be repaired primarily, provided tendon tissue can be identified; alternatively, autograft or allograft reconstruction can be considered, and good outcomes have been reported with both techniques.Cite this article: Alentorn-Geli E, Assenmacher AT, Sanchez-Sotelo J. Distal biceps tendon injuries: a clinically relevant current concepts review. EFORT Open Rev 2016;1:316-324. DOI: 10.1302/2058-5241.1.000053.

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Distal Biceps Brachii Tendon Repairs

Abstract: Both the single-incision CB and double-incision BT techniques provided excellent clinical results. Complications were more common in the single-incision CB group and most commonly involved paresthesias of the superficial radial nerve.

Cited by 50 publications

References 19 publications

Major complications after distal biceps tendon repairs: retrospective cohort analysis of 970 cases

Major complications after distal biceps tendon repairs: retrospective cohort analysis of 970 cases

No Significant Difference Between Intramedullary and Extramedullary Button Fixation for Distal Biceps Brachii Tendon Rupture After Cyclic Loading in a Cadaver Model

Distal biceps tendon injuries

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