Rupture of the distal biceps brachii tendon: conservative treatment versus anatomic reinsertion—clinical and radiological evaluation after 2 years
- 1k Downloads
- 57 Citations
Abstract
Introduction
Distal biceps tendon rupture is a relatively rare injury. It commonly occurs in the dominant extremity of middle-aged men during an excessive eccentric tension as the arm is forced from a flexed position, while it is rarely observed during sport activities. Many techniques, including non-operative and surgical option, have been described for the treatment of a ruptured distal biceps tendon, but there is still considerable controversy about the management of choice.
Material and methods
Nine patients affected with traumatic distal tendon ruptures of the biceps brachii were followed-up for a minimum of 24 months. Five patients underwent surgery (two-incision technique) and four patients were treated conservatively. Tendon readaptation to its origin was done by a suture metal anchor. Outcome was evaluated based on the physical examination, radiographic analysis and the SECEC elbow score.
Results
The SECEC elbow score results show that every single item result is in favour of surgical treatment. On measurements of motion, we found a slight flexion–extension deficit in two patients, but reduced supination in six patients and reduced pronation in four. Two patients had postoperative dysfunction of the deep branch of the radial nerve. Radiographic examination showed heterotopic bone formation on the radial tuberosity around the presumed insertion of the reattached tendon in 2 of 5 patients and ectopic ossification more proximally in the area of the biceps muscle
Conclusion
Our findings confirm the view that anatomic repair of distal biceps tendon rupture provides consistently good results and early anatomic reconstruction can restore strength and endurance for the elbow.
Keywords
Traumatic distal tendon ruptures of the biceps brachii Conservative treatment Anatomic reinsertionReferences
- 1.Balabaud L, Ruiz C, Nonnenmacher J, Seynaeve P, Kehr P, Rapp E (2004) Repair of distal biceps tendon ruptures using a suture anchor and an anterior approach. J Hand Surg [Br]. 29(2):178–182CrossRefGoogle Scholar
- 2.Bernstein AD, Breslow MJ, Jazrawi LM (2001) Distal biceps tendon ruptures: a historical perspective and current concepts. Am J Orthop. 30(3):193–200PubMedGoogle Scholar
- 3.Celli A, Nicoli E (2004) Fractures of the radial head associated with dislocation of the elbow. Chir Organi Mov 89(1):7–19PubMedGoogle Scholar
- 4.de Palma L, Delcogliano A (1984) Subcutaneous rupture of the distal tendon of the biceps brachii. Arch Putti Chir Organi Mov 34:281–286PubMedGoogle Scholar
- 5.Dojcinovic S, Maes R, Hoffmeyer P, Peter R (2004) Surgical treatment for distal rupture of the biceps tendon. Rev Chir Orthop Reparatrice Appar Mot 90(5):420–425PubMedGoogle Scholar
- 6.Gigante A, Marinelli M, Chillemi C, Greco F (2004) Fibrous cartilage in the rotator cuff: A pathogenetic mechanism of tendon tear? J Shoulder Elbow Surg 13(3):328–332PubMedCrossRefGoogle Scholar
- 7.Karunakar MA, Cha P, Stern PJ (1999) Distal biceps ruptures. Clin Orthop 363:100–107PubMedGoogle Scholar
- 8.Kobayashi K, Bruno RJ, Cassidy C (2003) Single anterior incision suture anchor technique for distal biceps tendon ruptures. Orthopedics 26(8):767–770PubMedGoogle Scholar
- 9.Leighton MM, Bush-Joseph CA, Bach BR (1995) Distal biceps brachii repair. Clin Orthop 317:114–121PubMedGoogle Scholar
- 10.Lynch SA, Beard DM, Renstrom PA (1999) Repair of distal biceps tendon rupture with suture anchors. Knee Surg Sports Traumatol Arthrosc 7(2):125–131PubMedCrossRefGoogle Scholar
- 11.Moosmayer S, Odinsson A, Holm I (2000) Distal biceps tendon rupture operated on with the Boyd-Anderson technique: follow-up of 9 patients with isokinetic examination after 1 year. Acta Orthop Scand 71(4):399–402PubMedCrossRefGoogle Scholar
- 12.Ozyurekoglu T, Tsai TM (2003) Ruptures of the distal biceps brachii tendon: results of three surgical techniques. Hand Surg 8(1):65–73PubMedCrossRefGoogle Scholar
- 13.Sassmannshausen G, Mair SD, Blazar PE (2004) Rupture of a bifurcated distal biceps tendon. A case report. J Bone Joint Surg 86-A(12):2737–2740PubMedGoogle Scholar
- 14.Seiler JG 3rd, Parker LM, Chamberland PD, Sherbourne GM, Carpenter WA (1995) The distal biceps tendon. Two potential mechanisms involved in its rupture: arterial supply and mechanical impingement. J Shoulder Elbow Surg 4(3):149–156PubMedCrossRefGoogle Scholar