RETRACTED: Clinical and functional impairment after nonoperative treatment of distal biceps ruptures

Schmidt, Christopher C.; Brown, Brandon T.; Schmidt, Daniel L.; Smolinski, Michael P.; Kotsonis, Thomas; Faber, Kenneth J.; Graham, Kraig S; Madonna, Tyler J.; Smolinski, Patrick; Miller, Mark Carl

doi:10.1016/j.jse.2018.09.017

Cited by 9 publications

(4 citation statements)

References 22 publications

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“…Unfortunately, the current research landscape is limited to a small number of retrospective case series 6 with the only prospective trial to date subsequently withdrawn from publication. 15 As with all survey-based data collection, there is potential for a response bias and the survey frame potentially also limits the generalisability of the findings of this survey -soft tissue elbow surgery also being undertaken by a proportion of hand surgeons or general trauma surgeons not represented in the BESS membership. The achieved response rate was low, although it was not that dissimilar from that achieved in similar surveys of the BESS surgical membership.…”

Section: Discussionmentioning

confidence: 99%

Treatment of acute distal biceps tendon ruptures – A survey of the British Elbow and Shoulder Society surgical membership

et al. 2021

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Background Acute distal biceps tendon ruptures result in weakness and deformity. While in other jurisdictions the rate of surgical repair has outpaced rises in incidence, UK practice for distal biceps tendon ruptures is unknown. The aim of this survey was to characterise current UK clinical practice. Methods An online survey was sent to the surgeon members of the British Elbow and Shoulder Society. Questions covered respondent demographics, clinical decision making, surgical experience and willingness to be involved in future research. Results A total of 242 surgeons responded; 99% undertook acute distal biceps tendon repairs with 83% repairing at least half of all distal biceps tendon ruptures, and 84% of surgeons would have their own, hypothetical, acute distal biceps tendon rupture repaired in their dominant arm and 67% for their non-dominant arm. Patient age, occupation and restoration of strength were the commonest factors underpinning a recommendation of surgical fixation. Most surgeons (87%) supported a national trial to study operative and non-operative treatments. Conclusions UK upper limb surgeons currently advise surgical repair of acute distal biceps tendon ruptures for the majority of their patients. This is despite a paucity of evidence to support improved outcomes following surgical, rather than non-operative, management. There is a clear need for robust clinical evaluation in this area.

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Section: Discussionmentioning

confidence: 99%

Treatment of acute distal biceps tendon ruptures – A survey of the British Elbow and Shoulder Society surgical membership

et al. 2021

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“…Distal biceps tears are common injuries and, left untreated, they lead to significant loss of supination strength. 1 As a result, the primary objective of distal biceps repair is restoration of supination strength. Both 1-and 2-incision techniques are successful, but each has its own advantages and disadvantages (Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…When treated nonoperatively, not only is there cosmetic deformity and some loss of elbow flexion strength but, most important, there is also significant loss of supination strength. 1 As a result, primary repair is indicated in most patients to restore function, particularly supination strength.…”

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confidence: 99%

Two-Incision Distal Biceps Repair with Cortical Button: A Technique to Improve Supination Strength

Amini

2021

Arthroscopy Techniques

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Tears of the distal biceps are common, and nonoperative treatment results in significant loss of supination strength. Surgery is indicated for most patients to restore this supination strength. Both 1-and 2-incision techniques are successful, but each has its own advantages and disadvantages. We believe the 2-incision technique better restores the anatomic attachment site of the tendon, which leads to better supination strength and has a lower rate of neurologic injury. Although it does have a slightly higher risk of synostis, this can be mitigated by routine prophylaxis with NSAIDs. Augmenting the repair with a cortical button has been shown to increase the load-to-failure better than the traditional 2incision technique that employs transosseous fixation. Here we present our technique of 2-incision distal biceps repair with cortical button, a technique intended to maximize supination strength.

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“…Surgery can sometimes be avoided by conservative management of partial or complete biceps ruptures; however, untreated complete distal biceps ruptures can result in an estimated loss of 40% to 60% of supination power and 30% of flexion power. Nevertheless, some patients may adapt well and even regain substantial strength during supination over time [51]. While functional challenges might endure, a study has reported that there could be a notable prevalence of lingering pain and weakness even after 4.5 years of follow-up after nonoperative treatment [52].…”

Section: Anterior Elbow Painmentioning

confidence: 99%

Recent Nonoperative Treatment of Elbow Pain

Han,

Jeon

2023

Ewha Med J

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Pain originating from the elbow can be due to issues affecting the joint itself or the structures surrounding it. These structures include the medial and lateral epicondyles, associated ligaments, the origins of wrist flexor and extensor muscles, the olecranon bursa, the distal biceps tendon, and the radial and ulnar nerves. Pain that appears to originate from a different location may actually be referred pain, potentially stemming from the neck (cervical radiculopathy) or the shoulder. Among complaints related to the elbow, lateral elbow pain is the most frequently reported. This pain could originate from the lateral epicondyle, the radiohumeral joint, or it could be referred pain from other areas. Medial elbow pain is the second most common complaint, often resulting from issues with the medial epicondyle or the ulnar nerve as it travels through the cubital tunnel. The biceps tendon is frequently the cause of anterior elbow pain. Patients who report swelling in the elbow are often experiencing olecranon bursitis. These conditions can often be effectively managed through conservative treatment. The aim of this article is to provide a structured approach to addressing patients with elbow pain, by detailing the common causes of such discomfort and exploring effective nonsurgical treatment options.

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RETRACTED: Clinical and functional impairment after nonoperative treatment of distal biceps ruptures

Cited by 9 publications

References 22 publications

Treatment of acute distal biceps tendon ruptures – A survey of the British Elbow and Shoulder Society surgical membership

Treatment of acute distal biceps tendon ruptures – A survey of the British Elbow and Shoulder Society surgical membership

Two-Incision Distal Biceps Repair with Cortical Button: A Technique to Improve Supination Strength

Recent Nonoperative Treatment of Elbow Pain

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