Skip to main content
SpringerLink
Log in

Biceps Tendon Pathology

  • Chapter
  • First Online:
Elbow and Sport

Abstract

Distal biceps tendon pathology includes a spectrum of conditions, from insertional tendinopathy to partial and complete tears of the tendon. While complete tears tend to be traumatic and occur with eccentric elbow flexion, partial tears can be related to an underlying systemic disease or anabolic steroid abuse, cause deep-seated anterior elbow pain and require a high index of suspicion for diagnosis. The signs of partial tears are often subtle and diagnosis may be difficult owing to unreliable clinical examination and imaging. Endoscopy may be used for diagnosis and provides detailed understanding of the pathoanatomy of the distal tendon where other modalities have failed. Tears may lead to significant deficits in supination strength and endurance when compared to the contralateral arm and often require repair. A number of operative techniques, including two-incision, single anterior incision and endoscopic distal biceps repair, have been used for those ruptures requiring repair. The aim of this chapter is to describe biceps pathology and the operative techniques used in tendon repair.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ramsey ML. Distal biceps tendon injuries: diagnosis and management. J Am Acad Orthop Surg. 1999;7(3):199–207.

    CAS  PubMed  Google Scholar 

  2. Baker BE, Bierwagen D. Rupture of the distal tendon of the biceps brachii. Operative versus non-operative treatment. J Bone Joint Surg Am. 1985;67(414):7.

    Google Scholar 

  3. Boyd HB, Anderson LD. A method for reinsertion of the distal biceps brachii tendon. J Bone Joint Surg Am. 1961;43:1041–3.

    Google Scholar 

  4. Dellaero DT, Mallon WJ. Surgical treatment of partial biceps tendon ruptures at the elbow. J Should Elbow Surg. 2006;15(2):215–7.

    Article  Google Scholar 

  5. Eames MHA, Bain GI. Distal biceps tendon endoscopy and anterior elbow arthroscopy portal. Tech Should Elbow Surg. 2006;7(3):139–42.

    Article  Google Scholar 

  6. Giuffre BM, Moss MJ. Optimal positioning for MRI of the distal biceps brachii tendon: flexed abducted supinated view. AJR Am J Roentgenol. 2004;182(4):944–6.

    Article  CAS  PubMed  Google Scholar 

  7. Phadnis J, Bain G. Endoscopic-assisted Distal Biceps Footprint Repair. Tech Hand Up Extrem Surg. 2015 Jun;19(2):55–9. doi: 10.1097/BTH.0000000000000078.

    Google Scholar 

  8. Safran MR, Graham SM. Distal biceps tendon ruptures: incidence, demographics, and the effect of smoking. Clin Orthop Relat Res. 2002;404:275–83.

    Article  PubMed  Google Scholar 

  9. Sharma S, MacKay G. Endoscopic repair of distal biceps tendon using an EndoButton. Arthroscopy. 2005;21(7):897.

    Article  PubMed  Google Scholar 

  10. Visuri T, Lindholm H. Bilateral distal biceps tendon avulsions with use of anabolic steroids. Med Sci Sports Exerc. 1994;26(8):941–4.

    Article  CAS  PubMed  Google Scholar 

  11. Abboud JA, Ricchetti ET, Tjoumakaris FP, Bartolozzi AR, Hsu JE. The direct radial tuberosity compression test: a sensitive method for diagnosing partial distal biceps tendon ruptures. Curr Orthop Pract. 2011;22(1):76.

    Article  Google Scholar 

  12. Athwal GS, Steinmann SP, Rispoli DM. The distal biceps tendon: footprint and relevant clinical anatomy. J Hand Surg [Am]. 2007;32(8):1225–9.

    Article  Google Scholar 

  13. Bain GI, Prem H, Heptinstall RJ, Verhellen R, Paix D. Repair of distal biceps tendon rupture: a new technique using the Endobutton. J Should Elbow Surg. 2000;9(2):120–6.

    Article  CAS  Google Scholar 

  14. Bain GI, Johnson LJ, Turner PC. Treatment of partial distal biceps tendon tears. Sports Med Arthrosc. 2008;16(3):154–61.

    Article  PubMed  Google Scholar 

  15. D’Alessandro DF, Shields Jr CL, Tibone JE, Chandler RW. Repair of distal biceps tendon ruptures in athletes. Am J Sports Med. 1993;21(1):114–9.

    Article  PubMed  Google Scholar 

  16. Dillon MT, Bollier MJ, King JC. Repair of acute and chronic distal biceps tendon ruptures using the EndoButton. Hand (N Y). 2011;6(1):39–46.

    Article  Google Scholar 

  17. Durr HR, Stabler A, Pfahler M, Matzko M, Refior HJ. Partial rupture of the distal biceps tendon. Clin Orthop Relat Res. 2000;(374):195-200.

    Google Scholar 

  18. Eames MHA, Bain GI, Fogg QA, van Riet RP. Distal biceps tendon anatomy: a cadaveric study. J Bone Joint Surg Am. 2007;89(5):1044–9.

    Article  CAS  PubMed  Google Scholar 

  19. Festa A, Mulieri PJ, Newman JS, Spitz DJ, Leslie BM. Effectiveness of magnetic resonance imaging in detecting partial and complete distal biceps tendon rupture. J Hand Surg [Am]. 2010;35(1):77–83.

    Article  Google Scholar 

  20. Freeman CR, McCormick KR, Mahoney D, Baratz M, Lubahn JD. Nonoperative treatment of distal biceps tendon ruptures compared with a historical control group. J Bone Joint Surg Am. 2009;91(10):2329–34.

    Article  PubMed  Google Scholar 

  21. Grégory T, Roure P, Fontès D. Repair of distal biceps tendon rupture using a suture anchor. Am J Sports Med. 2009;37(3):506–11.

    Article  PubMed  Google Scholar 

  22. Heinzelmann AD, Savoie FH, Ramsay JR, Field LD, Mazzocca AD. A combined technique for distal biceps repair using a soft tissue button and biotenodesis interference screw. Am J Sports Med. 2009;37(5):989–94.

    Article  PubMed  Google Scholar 

  23. Jarrett CD, Weir DM, Stuffmann ES, Jain S, Miller MC, Schmidt CC. Anatomic and biomechanical analysis of the short and long head components of the distal biceps tendon. J Should Elbow Surg. 2012;21(7):942–8.

    Article  Google Scholar 

  24. Mazzocca AD, Spang JT, Arciero RA. Distal biceps rupture. Orthop Clin N Am. 2008;39(2):237–49. vii.

    Article  Google Scholar 

  25. McKee MD, Hirji R, Schemitsch EH, Wild LM, Waddell JP. Patient-oriented functional outcome after repair of distal biceps tendon ruptures using a single-incision technique. J Should Elbow Surg. 2005;14(3):302–6.

    Article  Google Scholar 

  26. Morrey ME, Abdel MP, Sanchez-Sotelo J, Morrey BF. Primary repair of retracted distal biceps tendon ruptures in extreme flexion. J Should Elbow Surg. 2014;23(5):679–85.

    Article  Google Scholar 

  27. Nesterenko S, Domire ZJ, Morrey BF, Sanchez-Sotelo J. Elbow strength and endurance in patients with a ruptured distal biceps tendon. J Should Elbow Surg. 2010;19(2):184–9.

    Article  Google Scholar 

  28. O’Driscoll SW, Goncalves LB, Dietz P. The hook test for distal biceps tendon avulsion. Am J Sports Med. 2007;35(11):1865–9.

    Article  PubMed  Google Scholar 

  29. Peeters T, Ching-Soon NG, Jansen N, Sneyers C, Declerg G, Verstreken F. Functional outcome after repair of distal biceps tendon ruptures using the endobutton technique. J Should Elbow Surg. 2009;18(2):283–7.

    Article  Google Scholar 

  30. Smith J, Finnoff JT, O’Driscoll SW, Lai JK. Sonographic evaluation of the distal biceps tendon using a medial approach. J Ultrasound Med. 2010;29(5):861–5.

    PubMed  Google Scholar 

  31. Walschot LHB, Phadnis J, Bain GI. Endoscopic distal biceps repair, the elbow and wrist: AANA Advanced Arthroscopic Surgical Techniques. Publisher Slack, In Press.

    Google Scholar 

  32. Tanner C, Johnson T, Muradov P, Husak L. Single incision power optimizing cost-effective (SPOC) distal biceps repair. J Shoulder Elbow Surg. 2013;22(3):305-11. doi: 10.1016/j.jse.2012.10.044

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery and Trauma, Flinders University, Adelaide, SA, Australia

    Gregory Bain MBBS, FRACS, FA (Ortho)A, PhD, Joideep Phadnis MBChB, MRCS, Dip SportsMed, FRCS & Hani Saeed MD, BPharm

  2. Department of Orthopaedic Surgery and Trauma, Flinders Medical Centre, Adelaide, SA, Australia

    Gregory Bain MBBS, FRACS, FA (Ortho)A, PhD, Joideep Phadnis MBChB, MRCS, Dip SportsMed, FRCS & Hani Saeed MD, BPharm

Authors
  1. Gregory Bain MBBS, FRACS, FA (Ortho)A, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joideep Phadnis MBChB, MRCS, Dip SportsMed, FRCS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hani Saeed MD, BPharm
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gregory Bain MBBS, FRACS, FA (Ortho)A, PhD .

Editor information

Editors and Affiliations

  1. Nuovo Ospedale di Sassuolo, Sassuolo, Italy

    Luigi Adriano Pederzini

  2. Dept of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands

    Denise Eygendaal

  3. Istituto Clinico Humanitas, Rozzano, Milan, Italy

    Matteo Denti

Rights and permissions

Reprints and permissions

Copyright information

© 2016 ESSKA

About this chapter

Cite this chapter

Bain, G., Phadnis, J., Saeed, H. (2016). Biceps Tendon Pathology. In: Pederzini, L., Eygendaal, D., Denti, M. (eds) Elbow and Sport. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48742-6_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-48742-6_13

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-48740-2

  • Online ISBN: 978-3-662-48742-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation