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Reattachment of an avulsed distal biceps tendon in athletes

The two-incision technique according to Boyd and Anderson and modified by Bourne and Morrey
  • Michael BohnsackEmail author
  • Oliver Rühmann
  • Christof Hurschler
  • Constanze Börner
  • Carl Joachim Wirth
Original Article
  • 92 Downloads

Abstract

Refixation of the ruptured distal biceps tendon to the radial tuberosity in a two-incision technique restores power and function. Between 1995 and 1999 a refixation of the ruptured distal biceps brachii tendon on the tuberositas radii was performed in four athletes (three gymnasts and one American football player) using a two-incision-technique according to Boyd and Anderson (J Bone Joint Surg 43A:1041–1043, 1961) modified by Bourne and Morrey (Clin Orthop 271:143–148, 1991). The average age at surgery was 36 (23–48) years. The patients were followed up with a clinical examination and a questionnaire at an average of 82 (70–108) months postoperative. Flexion, extension and pronation was normal in all patients, although two patients had a reduction of forearm supination of 10° on the operated side. On a visual analogue scale, a subjective 5–10% reduction of forearm-flexion strength was reported by three patients. No decrease of flexion- or supination-strength was observed upon clinical examination. The subjective rating of the overall clinical outcome was “excellent” in three and “good” in one patient. Three patients rated “excellent” and one patient “good” according to the criteria of Rantanen and Orava (Am J Sports Med 27:128–132, 1999). We conclude that power and function can be restored through a refixation of the ruptured distal biceps tendon to the radial tuberosity in a two-incision technique. We recommend the method in athletes.

Keywords

Biceps tendon Rupture Reattachment High active Results 

Réinsertion d’une avulsion de tendon du long biceps chez des athlètes

Résumé

La réinsertion des ruptures distales du tendon du biceps sur la tubérosité bicipitale par une double voie d’abord rétablit force et fonction. Entre 1995 et 1999 la réinsertion des ruptures distales du biceps brachial sur la tubérosité bicipitale a été réalisée chez 4 athlètes (3 gymnastes et un joueur de football américain) à l’aide d’une technique à deux incisions selon Boyd et Anderson modifiée par Bourne et Morrey. L’âge moyen lors de l’intervention chirurgicale était de 36 ans (23–48). Les patients ont été réexaminés par un examen clinique et un questionnaire à une moyenne de 82 mois post-opératoires (70–108). La flexion, l’extension et la pronation étaient normales chez tous les patients, bien que deux patients aient une diminution de 10° de supination du côté opéré. Sur une échelle visuelle analogique, une diminution subjective de 5–10% de la force de flexion de l’avant-bras a été notée chez trois patients. Aucune diminution de force de flexion ou de supination n’a été observée à l’examen clinique. L’évaluation subjective du résultat clinique final était considérée comme “excellente” par trois patients et “bonne” par un patient. Le résultats de trois patients a été considérés comme “excellent” et un patient avait un “bon” résultat selon les critères de Rantanen et Orava. Nous concluons que la force et la fonction peuvent être rétablies par une réinsertion des ruptures du tendon de biceps distal sur la tubérosité bicipitale par une double voie d’abord. Nous recommandons cette technique chez les sportifs de haut niveau

Mots clés

Tendon du biceps Rupture Réinsertion Activité de haut niveau Résultats 

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Michael Bohnsack
    • 1
    Email author
  • Oliver Rühmann
    • 1
  • Christof Hurschler
    • 1
  • Constanze Börner
    • 1
  • Carl Joachim Wirth
    • 1
  1. 1.Department of Orthopaedic SurgeryHannover Medical SchoolHannoverGermany

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