Immediate Active Range of Motion after Modified 2-Incision Repair in Acute Distal Biceps Tendon Rupture

Abstract

A modified 2-incision distal biceps repair allows a safe immediate active range of motion protocol with early return of nearly full range of motion and strength, without any clinically significant disability.

Controversies in the surgical treatment of distal biceps tendon ruptures: single versus double-incision repairs

“…10 At a mean of 57 months follow-up, the average arc of elbow motion was 0-141 . Mean supination and pronation motions were 74 and 75 , respectively.…”

“…In the majority of cases, the presence of heterotopic bone does not restrict motion or affect the clinical outcome. 4,10,18,19,25,27,37,40 Reports of proximal radioulnar synostosis, although rare, were much more common with the Boyd and Anderson approach than with double-incision muscle-splitting or single-incision approaches. 4,11,14,26,32,37 With the advent of a doubleincision muscle-splitting approach in which the periosteal surface of the ulna is not violated, the incidence of synostosis and heterotopic bone have decreased substantially.…”

Proper placement of the distal biceps tendon during repair improves supination strength—a biomechanical analysis

“…In many of these papers, supination torque is tested only in a neutral rotation. 4,6,18,25 In one randomized trial, isometric testing was done with the arm in a neutral rotation. Although this study was very well done, this testing would not uncover the true weaknesses that may or may not exist if the repair was not anatomic and tested in the supinated position.…”

Repair of Distal Biceps Ruptures

“…Greenberg et al 14 reported 82% supination strength in 14 patients with repair via tendon in bone with an extracortical button. Cil et al 11 reported an average isometric supination strength 9% less than the unaffected side (range, 53% less to 108% more) after a modified 2-incision approach.…”