Surgical Treatment of Distal Biceps Ruptures

Mesenchymal stem cells in tendon repair and regeneration: basic understanding and translational challenges

“…Nonsurgical treatments for tendon injury and tendinopathy include nonsteroidal anti‐inflammatory drugs (NSAIDs), corticosteroid injections, exercise therapy, extracorporeal shock wave therapy, and platelet‐rich plasma; however, these treatment modalities have not been clearly demonstrated to cure tendinopathy or completely repair an injured tendon . On the other hand, surgical repair of tendon rupture is a common treatment option and can, in some cases, restore tendon function to near‐normal levels, as is seen in the surgical treatment of distal biceps ruptures and patellar tendon ruptures . However, in other cases, surgically repaired tendon is at risk of re‐rupture, at a rate equal or sometimes greater than conservative, nonoperative treatments .…”

Reinserção da ruptura distal do bíceps braquial mediante incisão única com uso de âncoras

“…Regarding the recovery of the operated limb strength, the results were similar to those reported in other studies with different techniques, ranging from 80% to 95% for elbow supination, and from 90% to 95% for elbow flexion. 2,6,8,[12][13][14]23 The postoperative development of heterotopic ossification was not observed in any of our patients, even though the group did not adopt a routine use of non-hormonal anti-inflammatory drugs, as this prophylaxis may increase the risk of gastrointestinal bleeding. One case of anchor release occurred during the recovery process, but it did not negatively affect objective tests results, representing a 6.6% complication rate, similar to that of studies published in the literature.…”

“…Our case series is consistent with worldwide findings, in which DBBT rupture is more common in the dominant limb of men between the fourth and fifth decades of life. 3,6 The literature describes several surgical techniques for the treatment of DBBT injury; the first of them is performed 2,4,6,8,[12][13][14][15][16][17] We chose to use a 4-cm forearm single anterior approach over the anterior radius tuberosity because it minimizes the dissection of soft tissue during the repair, as it does not cross syndesmosis, and provides direct access to the radial attachment site of the DBBT, enabling a more anatomical ulnar reinsertion and sparing the tuberosity. 8,15,22,23 In addition, this technique provides good esthetic results after healing (►Figure 6).…”

“…The degeneration of both the tendon and its insertion may contribute to this type of injury, as well as the use of anabolic steroids. [1][2][3][4][5][6][7] Active elbow movement resumes after the acute phase of the injury. However, DBBT rupture may result in an up to 30% of loss of flexion strength; loss of supination strength may be even more severe, reaching 40%.…”

“…The literature reports radial artery injury, median nerve injury, posterior interosseous nerve injury and proximal radioulnar synostosis as complications resulting from these techniques. 2,4,6,8,[12][13][14][15][16][17] In-depth knowledge of local anatomy minimizes postoperative complications. As a result, the transverse anterior approach at the radial tuberosity region is more anatomical and respects regional force lines; in addition, it does not cross the anterior elbow crease, avoiding cicatricial retractions.…”