Distal Biceps Tendon Ruptures

Kelly, Matthew C.; Perkinson, Scott G.; Ablove, Robert H.; Tueting, Jonathan L.

doi:10.1177/0363546515587738

Cited by 195 publications

(75 citation statements)

References 15 publications

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“…Distal biceps brachii tendon (DBBT) tendinopathy is a health condition infrequently seen in baseball players. DBBT injuries occur mainly in men aged 40-60 years old [1]. The typical mechanism of injury is a powerful extension force applied to the anterior aspect of the forearm with the elbow in an actively flexed position [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

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Multifaceted Exercise Prescription in the Management of an Overhead Athlete with Suspected Distal Biceps Tendinopathy: A Case Report

Holshouser¹,

Jayaseelan

2020

JFMK

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Background and Purpose: Distal biceps brachii tendinopathy is an uncommon diagnosis. Various exercise prescriptions have demonstrated efficacy in the management of tendinopathy, although studies frequently focus on the effects of a specific type of muscular contraction (i.e., concentric, isometric, or eccentric). Currently, there is limited research guiding the conservative management of distal biceps tendinopathy, particularly with overhead athletes, and even less evidence reporting a multifaceted exercise prescription for individuals with tendinopathy. The purpose of this case report is to describe the integration of various modes of therapeutic exercise into a rehabilitation program for an overhead athlete with suspected distal biceps brachii tendinopathy. Case Description: A 19-year-old male collegiate baseball pitcher presented to an outpatient physical therapy clinic via direct access for left antecubital pain, which began 6 weeks prior to the evaluation while pitching during try-outs. Following physical examination, distal biceps tendinopathy was the likely clinical diagnosis. Interventions focused on early eccentric exercise eventually progressing to concentric and plyometric activity for return to sport. Outcomes: The patient was seen five times over the course of 4 weeks. He had significant improvements of pain, patient-reported functional outcomes, global rating of change, strength, tenderness, and provocation testing. The patient was able to return to an off-season pitching program. Discussion: An impairment-based and task-specific exercise prescription was effective for this patient with distal biceps tendinopathy. Understanding the biomechanical demands of an individual’s functional limitation, in this case baseball pitching, may assist the decision-making process and optimize outcomes. Additional research into the most effective exercise prescriptions for individuals with uncommon tendinopathies is warranted.

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Section: Introductionmentioning

confidence: 99%

“…DBBT injuries occur mainly in men aged 40-60 years old [1]. The typical mechanism of injury is a powerful extension force applied to the anterior aspect of the forearm with the elbow in an actively flexed position [1][2][3][4][5]. The rate of DBBT injuries have been reported to be as low as 1.2 per 100,000 people each year [1,3,[6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Multifaceted Exercise Prescription in the Management of an Overhead Athlete with Suspected Distal Biceps Tendinopathy: A Case Report

Holshouser¹,

Jayaseelan

2020

JFMK

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“…The number of reported DBT tears seems to have increased over the last few years, likely related to better understanding and improved diagnostic methods. 1 While some individuals may maintain reasonable function after non-operative treatment of a ruptured DBT, biomechanical and clinical studies suggest that most individuals benefit from surficial repair or reconstruction. 2 Over the last decade, there has been a substantial increase in the number of studies focussed on DBT tears, mostly reporting on biomechanical and clinical outcomes depending on the surgical technique or fixation method.…”

Section: Introductionmentioning

confidence: 99%

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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“…6,13 The injury is most common in the dominant extremity, with less load to failure noted as the elbow moves toward a flexion angle of 90°. 16 The pathogenesis leading to distal biceps ruptures has been proposed as mechanical impingement of the tendon during forearm rotation as well as a hypovascular zone contributing to attritional ruptures.…”

mentioning

confidence: 99%

“…15 As the incidence of distal biceps ruptures has shown increases from previous studies, the treatment of this condition is of continued importance. 6 …”

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confidence: 99%

Radiostereometric Evaluation of Tendon Elongation After Distal Biceps Repair

Marshall

Keller

Okoroha

et al. 2016

Orthopaedic Journal of Sports Medicine

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Background:Operative repair of distal biceps tendon ruptures has shown successful outcomes. However, little is known about the amount of tendon or repair site lengthening after repair.Purpose/Hypothesis:The purpose of this study was to evaluate distal biceps tendon repair via intratendinous radiostereometric analysis to analyze tendon lengthening at different time intervals of healing. The hypothesis was that there is significant lengthening after repair.Study Design:Case series; Level of evidence, 4.Methods:Eleven patients with distal biceps ruptures requiring operative repair were recruited. During repair, two 2-mm tantalum beads with laser-etched holes were sutured to the distal biceps tendon. Beads were evaluated via computed tomography scans immediately postoperatively and at 16 weeks. Radiographs were obtained at time 0 and then at 4, 8, and 16 weeks postoperatively. Measurements were made using the button-to-bead and bead-to-bead distances to assess repair site elongation as well as tendon elongation over time. After final follow-up, patients filled out the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and underwent ultrasound to confirm the integrity of the tendon.Results:Ten patients had complete ruptures, with 1 having a partial rupture that underwent completion of the tear and subsequent repair. All patients showed statistically significant lengthening after surgery. The mean amount of tendon lengthening after surgery was 22.8 mm (range, 11.2-30.9 mm; P < .05), and the repair site lengthened a mean 17.0 mm (range, 9.6-30.6 mm; P < .05) from surgery to final follow-up. The greatest change in lengthening was noted between time 0 and week 4 (mean, 11.3 mm; P < .05), with the least amount of lengthening between weeks 8 and 16 (mean, 2.6 mm; P < .05). The mean DASH score was 11.2. Final ultrasound evaluations found all tendons to be in continuity.Conclusion:All patients undergoing distal biceps tendon repair have significant elongation after surgery, with the greatest amount of lengthening seen in the early postoperative period.

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Distal Biceps Tendon Ruptures

Abstract: The incidence of distal biceps tendon ruptures in this study was higher than previously reported.

Cited by 195 publications

References 15 publications

Multifaceted Exercise Prescription in the Management of an Overhead Athlete with Suspected Distal Biceps Tendinopathy: A Case Report

Multifaceted Exercise Prescription in the Management of an Overhead Athlete with Suspected Distal Biceps Tendinopathy: A Case Report

Distal biceps tendon injuries

Radiostereometric Evaluation of Tendon Elongation After Distal Biceps Repair

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