Repair of Distal Biceps Ruptures

Baratz, Mark E.; King, Graham J.W.; Steinmann, Scott P.

doi:10.1016/j.jhsa.2012.02.008

Cited by 13 publications

(5 citation statements)

References 18 publications

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confidence: 99%

“…The most common nerves involved are typically the lateral antebrachial cutaneous (LABC) nerve, anterior interosseous nerve (AIN), posterior interosseous nerve (PIN), median, radial, and ulnar nerves. 2,3,7,9,18,24,28,39,41 The purpose of this meta-analysis was to compare the complication rates of single-incision versus doubleincision distal biceps fixation procedures, particularly the rates of nerve injury, heterotopic ossification, and rerupture. We hypothesized that single-incision repairs would have greater rates of nerve injury, double-incision repairs would have greater rates of heterotopic ossification, and that there would be no difference in rerupture rates.…”

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confidence: 99%

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Complications of Distal Biceps Tendon Repair

Amin

Volpi

Lynch

et al. 2016

Orthopaedic Journal of Sports Medicine

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Background:Anatomic reinsertion of the distal biceps is critical for restoring flexion and supination strength. Single- and double-incision surgical techniques have been reported, analyzing complications and outcomes measures. Which technique results in superior clinical outcomes and the lowest associated complications remains unclear.Hypothesis:We hypothesized that rerupture rates would be similar between the 2 techniques, while nerve complications would be higher for the single-incision technique and heterotopic ossification would be more frequent with the double-incision technique.Study Design:Systematic review and meta-analysis; Level of evidence, 4.Methods:A systematic review was conducted using the PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SPORTSDiscus, and the Cochrane Central Register of Controlled Trials databases to identify articles reporting distal biceps ruptures up to August 2013. We included English-language articles on adult patients with a minimum of 3 cases reporting single- and double-incision techniques. Frequencies of each complication as a percentage of total cases were calculated. Fisher exact tests were used to test the association between frequencies for each repair method, with P < .05 considered statistically significant. Odds ratios with 95% CIs were also computed.Results:A total of 87 articles met the inclusion criteria. Lateral antebrachial cutaneous nerve neurapraxia was the most common complication in the single-incision group, occurring in 77 of 785 cases (9.8%). Heterotopic ossification was the most common complication in the double-incision group, occurring in 36 of 498 cases (7.2%).Conclusion:The overall frequency of reported complications is higher for single-incision distal biceps repair than for double-incision repair. The frequencies of rerupture and nerve complications are both higher for single-incision repairs while the frequency of heterotopic ossification is higher for double-incision repairs. These findings can help surgeons make better-informed decisions about surgical technique and provide their patients with detailed information about expected outcomes and possible complications.

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confidence: 99%

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confidence: 99%

Complications of Distal Biceps Tendon Repair

Amin

Volpi

Lynch

et al. 2016

Orthopaedic Journal of Sports Medicine

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“…Although a number of studies show statistically significant effects of this prophylaxis, its actual clinical value has not been definitively clarified. 1 , 3 , 7 …”

Section: Discussionmentioning

confidence: 99%

“…Unrepaired distal biceps tendon ruptures are often associated with a permanent loss of flexion and supination strength of 30%-50%. 3 By contrast, surgical reinsertion leads to highly satisfying results. 8 , 23 …”

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Clinical outcomes after refixation of subacute repaired distal biceps tendon ruptures

Thiele¹,

König²,

Kerschbaum³

et al. 2022

JSES International

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“…This was likely due to surgeon hesitation about inadequate restoration of supination strength with biceps-to-brachialis tenodesis. 8 Supination strength may remain significantly lower than the opposite side without substantial functional consequence, [25][26][27] suggesting that restoration of supination strength may not be as critical to recovery as once believed. 4 and loss of forearm motion occurring in 9.8%, 4.2%, and 5.2% of cases, respectively.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Distal Biceps Tendon Ruptures Using Biceps-to-Brachialis Tenodesis

Hotchkiss

2013

Techniques in Shoulder &Amp; Elbow Surgery

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Anatomic repair of a ruptured distal biceps tendon can lead to restoration of good to excellent function, but there are many reports of complications that substantially compromise function. Loss of forearm rotation (pronation/supination) from errors in placement of the tendon attachment, bunching of the repair, tendon adhesion, or heterotopic ossification with incomplete or complete radioulnar synostosis is frequently described. Less commonly reported, but more devastating, are injuries to the radial nerve. The goals of distal biceps repair are reduction of pain and restoration of strength without loss of mobility. As the need for supination power and endurance provided by the biceps can be accommodated by the supinator, tenodesis to the brachialis offers another option for restoring elbow flexion function while avoiding the risks of the complications listed above. This is not a new idea, but previous technical descriptions of the procedure have provided little detail. We present a detailed description of our surgical technique and postoperative management and describe a case series of 5 patients with short-term follow-up and limited clinical outcomes. All patients had relief of their preoperative pain and were satisfied with their procedure. We have not encountered any complications to date and believe that biceps-to-brachialis tenodesis can successfully be used as an alternative to anatomic repair for acute distal biceps ruptures and failed prior repairs.

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Repair of Distal Biceps Ruptures

Cited by 13 publications

References 18 publications

Complications of Distal Biceps Tendon Repair

Complications of Distal Biceps Tendon Repair

Clinical outcomes after refixation of subacute repaired distal biceps tendon ruptures

Treatment of Distal Biceps Tendon Ruptures Using Biceps-to-Brachialis Tenodesis

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