The Distal Biceps Tendon: Footprint and Relevant Clinical Anatomy

Athwal, George S.; Steinmann, Scott P.; Rispoli, Damian M.

doi:10.1016/j.jhsa.2007.05.027

Cited by 186 publications

(159 citation statements)

References 10 publications

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“…This is in agreement with Dirim et al [6] and at variance with the description given by Athwal et al [1] and Eames et al [7]. It was observed that there was considerable contribution from the short head to the proximal part of BA and in many instances it was in the form of strong musculotendinous fibres.…”

Section: Discussionsupporting

confidence: 92%

“…Further, they have stated that the short and long head offer varying contribution not only to the distal tendon of biceps brachii but also to the BA [6]. Athwal et al [1] reported that the BA originated from the distal part of short head of the biceps in all 15 specimens studied; whereas, Eames et al [7] stated major role of long head in the formation of BA. Dirim et al [6] have reported that the BA is formed by superficial tendinous fibres arising from both muscle bellies.…”

Section: Discussionmentioning

confidence: 95%

“…Athwal et al [1] reported that the BA originates from the short head of the biceps but have not mentioned any contribution from the long head in the formation of BA. Dirim et al [6] have reported that the BA was formed by superficial tendinous fibres arising from both short and long head.…”

Section: Discussionmentioning

confidence: 99%

“…Athwal et al [1] reported that the BA originated from the distal part of short head of the biceps brachii in all 15 specimens studied; whereas, Eames et al [7] stated major role of long head in the formation of BA. They have also reported the presence of 3 layers of the aponeurosis [7].…”

Section: Introductionmentioning

confidence: 94%

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Morphology of the bicipital aponeurosis: a cadaveric study

Joshi¹,

Yogesh

Mittal

et al. 2014

Folia Morphol

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

See 2 more Smart Citations

Morphology of the bicipital aponeurosis: a cadaveric study

Joshi¹,

Yogesh

Mittal

et al. 2014

Folia Morphol

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show abstract

“…The results of this study suggest that most distal biceps brachii tendons have multiple connections between the tendinous bands that originate from each muscle belly. Suggestion that the two heads independently serve the dual function of the muscle (flexion and supination) (Athwal et al, 2007;Eames et al, 2007) cannot be supported by these data.…”

Section: Discussionmentioning

confidence: 90%

Distal biceps brachii tendon anatomy revisited from a surgical perspective

et al. 2009

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The distal biceps brachii tendon is commonly susceptible to traumatic injury. This study aimed to describe the morphology of the distal biceps brachii tendon in relation to the commonly used endobutton repair of tendon rupture. The results suggested that the distal tendon is a series of distinct bands of variable number. These bands are obscured surgically by the tendon sheath. Upon opening this sheath, blunt dissection of the tendon released fibrous connections between the tendon bands. Adjacent bands were variably connected via small oblique bands. The separations between bands were continuous onto the radius. They were therefore considered as separate force-conducting units. This notion is of high relevance to endobutton repairs, as the sutures are typically only passed through the margins of the tendon. Where few connections exist between tendinous bands, this represents a potential weakness, as central bands are therefore free to be pulled proximally. This is of primary concern in the early rehabilitative stages of postoperative care. It may be suggested that sutures that cross the width of the tendon will eliminate the give of central bands, improving postoperative results, reducing revision numbers, and potentially reducing rehabilitation time.

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A novel clinical test for partial tears of the distal biceps brachii tendon: The TILT sign

Shim

Strauch

2018

Clinical Anatomy

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Partial tears of the distal biceps brachii tendon are rare. A complete tear of the distal biceps brachii tendon is readily diagnosed on the basis of history and physical examination and has a well-described clinical presentation of acute pain in the antecubital fossa, localized tenderness, swelling, palpable defect, positive hook test, and weakness in forearm supination and elbow flexion. Partial tears, on the other hand, can present more subtly and remain a diagnostic challenge. We present a novel physical examination technique that utilizes the rotational anatomy of the radius. The patient's forearm is passively supinated and pronated with the elbow flexed to 90° while the examiner firmly palpates the dorsal forearm overlying the radial tuberosity. The tuberosity presents itself beneath the examining fingers only in full forearm pronation. A positive test is indicated by tenderness over the radial (or lateral) aspect of the tuberosity (TILT sign) only in full forearm pronation, and not in supination. We have found this diagnostic test to be 100% sensitive for diagnosing partial distal biceps brachii tendon tears over the last five years during which it has been in use. Representative example cases are presented. A positive TILT sign indicates a diagnosis of partial tear of the distal biceps brachii tendon. This simple diagnostic maneuver could facilitate earlier detection of these injuries. Clin. Anat. 31:301-303, 2018. © 2017 Wiley Periodicals, Inc.

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The Distal Biceps Tendon: Footprint and Relevant Clinical Anatomy

Cited by 186 publications

References 10 publications

Morphology of the bicipital aponeurosis: a cadaveric study

Morphology of the bicipital aponeurosis: a cadaveric study

Distal biceps brachii tendon anatomy revisited from a surgical perspective

A novel clinical test for partial tears of the distal biceps brachii tendon: The TILT sign

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