Distal Rupture of the Tendon of Biceps Brachii

Abstract

We report ten cases of rupture of the distal part of the tendon of biceps brachii in patients aged from 27 to 58 years. MRI allowed assessment of the degree of retraction of the tendon which was related to the integrity of the bicipital expansion. When the retraction exceeded 8 cm the expansion was always ruptured. When there was doubt, or in longstanding injury, MRI allowed the lesions to be defined.Surgical repair was by reinsertion on the radial tuberosity at one or two fixation points in eight patients and reinsertion on the anterior brachial muscle in one. The other patient refused surgery. The MRI findings were confirmed at operation. Use of fixation points allowed minimal intervention, thereby reducing the risk of damaging the radial nerve. One year after operation, dynamometric evaluation of the strength of flexion and supination confirmed that the best results were obtained by reinsertion to the radial tuberosity.

Repair of chronic distal biceps tendon ruptures using autologous hamstring graft and the Endobutton

“…Even allowing for compensation by brachioradialis hypertrophy, most authors agree that supination remains weaker if the tendon is not reattached to the tuberosity. 5,11 This was also demonstrated by the Cybex testing ( Figure 4). …”

Distal biceps tendon rupture operated on with the Boyd-Anderson technique: Follow-up of 9 patients with isokinetic examination after 1 year

“…Complications like postoperative radial nerve palsy (Sleebom andRegort 1991, Bak et al 1992) and motion-limiting soft-tissue calcification (Failla et al 1990, Karunakar et al 1999) have led to technical modifications with use of bone anchors (Verhaven et al 1993, Le Huec et al 1996 and limited dorsal exposure (Failla et al 1990, D'Arco et al 1998.…”

Patient-oriented functional outcome after repair of distal biceps tendon ruptures using a single-incision technique

“…2,6 The most current and generally accepted treatment for rupture of the distal biceps insertion is anatomic repair into the radial tuberosity. 1,2,[7][8][9][10][11][12][13] This repair is considered to reconstitute near-normal flexion and supination strength to the extremity and is the treatment of choice for most active patients. 2,5,14,15,17,20 The majority of reports in the literature focus on the 2-incision technique described by Boyd and Anderson 4 in 1961, which was developed to diminish the likelihood of radial nerve damage with the anterior surgical approach for this condition.…”