Abstract
The distal biceps tendon (DBT) anatomy is complex; the tendon passes through different planes across the arm and cubital fossa and inserts into a distinct footprint at the bicipital tuberosity. The DBT is closely related to several vital neurovascular structures along its course, and these structures are potentially at-risk during open and endoscopic surgery. Dynamic rotation draws the DBT through the narrow proximal radioulnar space and predisposes the tendon to impingement and wear. Dynamic rotation significantly alters the relationship of DBT insertion with the adjacent neurovascular structures and the insertion can be used as an intraoperative reference point for predicting the position of major neurovascular structures during surgery. Detailed knowledge of the structural morphometry and neurovascular anatomy of the DBT is necessary to safely replicate DBT kinematics during repair and reconstructive surgery for distal biceps pathology.
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References
Bhatia DN, Kandhari V, DasGupta B. Cadaveric study of insertional anatomy of distal biceps tendon and its relationship to the dynamic proximal radioulnar space. J Hand Surg Am. 2017;42(1):e15–23.
Bhatia DN. Endoscopic distal biceps repair: endoscopic anatomy and dual-anchor repair using a proximal anterolateral “parabiceps portal”. Arthrosc Tech. 2015;4:e785–93. https://doi.org/10.1016/j.eats.2015.07.031.
Bhatia DN. Endoscopic repair of acute and chronic retracted distal biceps ruptures. J Hand Surg Am. 2016;41(12):e501–7. https://doi.org/10.1016/j.jhsa.2016.09.008.
Phadnis J, Bain G. Endoscopic-assisted distal biceps footprint repair. Tech Hand Up Extrem Surg. 2015;19:55–9.
Eames MJ, Bain GI. Distal biceps tendon endoscopy and anterior elbow arthroscopy portal. Tech Shoulder Elb Surg. 2006;7:139–42.
Bhatia D, Naskar R, DeNiese P. Dynamic rotational alteration in positional relationship of neurovascular structures and distal biceps tendon insertion: a cadaveric study. J ISAKOS. 2019;4:296–301.
Bhatia DN, DasGupta B, Panjwani T. Cadaveric study of anterior and posterior elbow endoscopy portals for endoscopic distal biceps repair: comparative anatomy-at-risk. Surg Radiol Anat. 2016;38(7):781–91. https://doi.org/10.1007/s00276-016-1637-6. [Epub 2016 Feb 9].
Bhatia DN. Distal biceps tendon insertional trifurcation and a new footprint configuration: case report of an anatomical variant. Eur J Anat. 2020;24(3):235–8.
Eames MH, Bain GI, Fogg QA, et al. Distal biceps tendon anatomy: a cadaveric study. J Bone Joint Surg Am. 2007;89(5):1044–9.
Mazzocca AD, Cohen M, Berkson E, et al. The anatomy of the bicipital tuberosity and distal biceps tendon. J Shoulder Elb Surg. 2007;16(1):122–7.
Hutchinson HL, Gloystein D, Gillespie M. Distal biceps tendon insertion: an anatomic study. J Shoulder Elb Surg. 2008;17(2):342–6.
Rausch V, Krieter JP, Leschinger T, et al. The radioulnar distance at the level of the radial tuberosity. Clin Anat. 2019; https://doi.org/10.1002/ca.23483. [Published online ahead of print 2019 Oct 1].
Zeltser DW, Strauch RJ. Vascular anatomy relevant to distal biceps tendon repair. J Shoulder Elb Surg. 2016;25:283–8. https://doi.org/10.1016/j.jse.2015.08.042.
Honma S, Tokiyoshi A, Kawai K, Koizumi M, Kodama K. Radial artery running beneath the biceps tendon and its interrelation between the radial recurrent arteries. Anat Sci Int. 2008;83(4):232–8.
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Bhatia, D.N. (2022). Distal Biceps Anatomy: Structural Morphometry and Dynamic Relationships. In: Bhatia, D.N., Bain, G.I., Poehling, G.G., Graves, B.R. (eds) Arthroscopy and Endoscopy of the Elbow, Wrist and Hand. Springer, Cham. https://doi.org/10.1007/978-3-030-79423-1_47
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DOI: https://doi.org/10.1007/978-3-030-79423-1_47
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