Operative Treatment of Chronic Distal Biceps Tendon Ruptures

Hamer, M. Jake; Caputo, Andrew E.

doi:10.1097/jsa.0b013e3181824e76

Cited by 41 publications

(33 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Surgical debridement and reattachment is only warranted in patients who fail to respond to conservative management (24,30,34,35). The majority of patients with complete tears require immediate surgical reattachment of the biceps tendon to the bicipital tuberosity (36), as delayed reconstruction of the tendon can be more challenging and have a poorer functional outcome (24,30,(37)(38)(39).…”

Section: Anterior Tendon Pathologymentioning

confidence: 99%

Magnetic resonance imaging of the elbow

Stevens

2010

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Elbow pain is frequently encountered in clinical practice and can result in significant morbidity, particularly in athletes. Magnetic resonance imaging (MRI) is an excellent diagnostic imaging tool for the evaluation of soft tissue and osteochondral pathology around the elbow. Recent advances in magnetic field strength and coil design have lead to improved spatial resolution and superior soft tissue contrast, making it ideal for visualization of complex joint anatomy. This article describes the normal imaging appearances of anatomy around the elbow and reviews commonly occurring ligamentous, myotendinous, neural, and bursal pathology around the elbow.

show abstract

Section: Anterior Tendon Pathologymentioning

confidence: 99%

Magnetic resonance imaging of the elbow

Stevens

2010

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

“…16 However, current advancements in reconstructive surgical techniques have led to improved function and decreased complications resulting from surgical intervention. 2,5 Thus, operative fixation is currently recommended for most patients with chronic distal biceps tendon ruptures, except those who are low demand or not fit for surgery. 2 We have presented a series of chronic distal biceps tendon reconstructions using a fascia lata autograft, performed through a modified, anterior approach and secured to the biceps tubercle with suture anchors.…”

Section: Discussionmentioning

confidence: 99%

“…In general, reconstruction, rather than primary repair, is necessary after 6 weeks due to tendon retraction, scar formation and tissue atrophy. 5 Operative techniques described include tenodesis to the brachialis and anatomic reconstruction using tendon grafts. 6 Graft options include local lacertus fibrosis, 5 autograft semitendinosis, 7 split flexor carpi radialis, 8 palmaris longus 9 and fascia lata, 10 and Achilles tendon allograft.…”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4] A recent increase in understanding of distal biceps anatomy and function has led to the general recommendation for anatomic repair or reconstruction for both acute and chronic distal biceps tendon ruptures. 2,5 Distal biceps tendon rupture can be considered chronic after 3 to 12 weeks. In general, reconstruction, rather than primary repair, is necessary after 6 weeks due to tendon retraction, scar formation and tissue atrophy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Reconstruction of Chronic Distal Biceps Tendon Rupture using Fascia Lata Autograft

Morrell¹,

Mercer²,

Moneim³

2012

The Duke Orthopaedic Journal

View full text Add to dashboard Cite

Introduction: Distal biceps tendon ruptures are a rare injury and surgical reconstruction is typically recommended for chronic ruptures. There is no consensus regarding the most appropriate reconstruction technique. We present our experience with fascia lata autograft reconstructions of chronic distal biceps tendon ruptures using a modified single incision technique and distal fixation with suture anchors. Materials and methods:We retrospectively reviewed the outcome of 12 male patients with chronic distal biceps tendon ruptures who had reconstruction using a fascia lata autograft through a single anterior approach. The age ranged from 29 to 62 years. The average delay to surgery was 26.5 weeks (range 6-68 weeks). A modified single anterior incision was utilized for all patients. Fascia lata autograft was attached distally to the bicipital tuberosity using suture anchors. Tension was set with the elbow in 50° of flexion. The average follow-up was 14.5 months (range 1.5-66 months). All patients were treated by the senior author (MSM). Results:Eleven patients (92%) reported subjective improvement in elbow flexion and supination strength, as well as painless range of motion. The average elbow flexion/ extension arc was 126° (5° flexion to 131° flexion) and the average supination/pronation arc was 167 degrees (87°p ronation to 80° supination). Five patients underwent isokinetic flexion strength testing which revealed a restoration of 86% of strength when compared to the uninvolved side. Four patients underwent supination isokinetic strength testing which revealed a restoration of 87% of strength when compared to uninvolved side. Four patients reported numbness in the superficial radial nerve distribution that recovered within 12 months. There were no cases of heterotopic ossification or graft rupture. There was one case of wound dehiscence at the elbow that required local flap coverage and went on to heal uneventfully. Aside from a small muscle bulge at the donor site, there were no donor site complications. Conclusion:To our knowledge, this is the largest case series of patients undergoing distal biceps tendon reconstruction using fascia lata autograft. Our study has demonstrated a low complication rate with functional results similar to those reported in the literature utilizing a similar technique. We conclude that this technique offers a surgical treatment alternative that yields satisfactory functional outcomes with a low risk of complication.

show abstract

“…Some authors have suggested using the lacertus fibrosus as a local graft source in chronic DBT tears. 16 …”

Section: Relevant Anatomymentioning

confidence: 99%

Distal biceps tendon injuries

2016

View full text Add to dashboard Cite

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.

show abstract

Operative Treatment of Chronic Distal Biceps Tendon Ruptures

Cited by 41 publications

References 22 publications

Magnetic resonance imaging of the elbow

Magnetic resonance imaging of the elbow

Reconstruction of Chronic Distal Biceps Tendon Rupture using Fascia Lata Autograft

Distal biceps tendon injuries

Contact Info

Product

Resources

About