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Surgical repair of the distal biceps brachii tendon: clinical and isokinetic long-term follow-up

  • Sports Medicine
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Anatomical reinsertion of the avulsed distal biceps tendon is the recommended treatment, but the results are hampered by complications. The purpose of this study is to show the results of patients surgically treated with a non-anatomical reinsertion of this tendon. From 1972 to 2006, 26 non-professional athletic patients were surgically treated by suture of the tendon on the brachialis muscle tendon. At follow-up 23/26 patients underwent clinical and isokinetic evaluation. At a medium follow-up of 84 months, patients provided satisfactory subjective and objective clinical results. Flexion was restored in all patients, while a 10° supination deficit was found in two patients. Dynamometric tests showed satisfactory results both regarding Maximum Strength Power and Endurance tests. Reinsertion of the distal biceps tendon on the brachialis tendon can be considered, in a long-term follow-up, a safe and effective procedure, with low complication rate.

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References

  1. Azar FM, Loeb M (2003) Repair of acute distal biceps tendon ruptures. Oper Tech Sports Med 11:32–35

    Article  Google Scholar 

  2. Baker BE, Bierwagen D (1985) Rupture of the distal tendon of the biceps brachii. Operative versus non-operative treatment. J Bone Joint Surg 67A:414–417

    Google Scholar 

  3. Bell RH, Wiley WB, Noble JS, Kuczynski DJ (2000) Repair of distal biceps brachii tendon ruptures. J Shoulder Elbow Surg 9:223–226

    Article  PubMed  CAS  Google Scholar 

  4. Bisson L, Moyer M, Lanighan K, Marzo J (2008) Complications associated with repair of a distal biceps rupture using the modified two-incision technique. J Shoulder Elbow Surg 17:67s–71s

    Article  PubMed  Google Scholar 

  5. Boyd HB, Anderson LD (1961) A method of reinsertion of the distal biceps brachii tendon. J Bone Joint Surg 43A:1041–1043

    Google Scholar 

  6. Carroll RE, Hamilton LR (1967) Rupture of biceps brachii: a conservative method of treatment. J Bone Joint Surg 49A:1016

    Google Scholar 

  7. D’Alessandro DF, Shields CL Jr, Tibone JE, Chandler RW (1993) Repair of distal biceps tendon ruptures in athletes. Am J Sports Med 21:114–119

    Article  PubMed  Google Scholar 

  8. Davies GJ (1992) A compendium of isokinetics in clinical usage and rehabilitation techniques, 4th edn. S & S Publishers, Onasaka

  9. Davis WM, Yassine Z (1956) An etiological factor in tear of the distal tendon of the biceps brachii. J Bone Joint Surg 38A(6):1365–1368

    Google Scholar 

  10. Davison BL, Engber WD, Tigert LJ (1996) Long term evaluation of repaired distal biceps brachii tendon ruptures. Clin Orthop Relat Res 333:186–191

    Article  PubMed  Google Scholar 

  11. El-Hawary R, Macdermic JC, Faber KJ, Patterson SD, King GJ (2003) Distal biceps tendon repair: comparison of surgical techniques. J Hand Surg (Am) 28:496–502

    Article  Google Scholar 

  12. Failla JM, Amadio PC, Morrey BF, Beckenbaugh RD (1990) Proximal radioulnar synostosis after repair of distal biceps brachii rupture by the two-incision technique. Report of our cases. Clin Orthop Relat Res 253:133–136

    PubMed  Google Scholar 

  13. Gallagher MA, Cuomo F, Polonsky L, Berliner K, Zuckerman JD (1997) Effects of age, testing speed and arm dominance on isokinetic strength of the elbow. J Shoulder Elbow Surg 6:340–346

    Article  PubMed  CAS  Google Scholar 

  14. Gilcreest EL, Albi P (1939) Unusual lesions of muscles and tendons of the shoulder girdle and upper arm. Surg Gynecol Obstet 68:903–917

    Google Scholar 

  15. Henry AK (1957) The distal part of the humerus exposed in continuity with antecubital structures. In: Extensile exposure, edn 2, E.&S. Livingstone Ltd., Edinburgh, pp 90–93

  16. Kelly EW, Morrey BF, O’Driscoll SW (2000) Complications of repair of the distal biceps tendon with the modified two-incision technique. J Bone Joint Surg Am 82:1575–1581

    PubMed  Google Scholar 

  17. Klonz A, Loitz D, Wohler P, Reilmann H (2003) Rupture of the distal biceps brachii tendon: isokinetic power analysis and complications after anatomic reinsertion compared with fixation to the brachialis muscle. J Shoulder Elbow Surg 12:607–611

    Article  PubMed  Google Scholar 

  18. Krushinski EM, Brown JA, Murti AM (2007) Distal biceps tendon rupture: biomechanical analysis of repair strength of the Bio-Tenodesis screw versus suture anchors. J Shoulder Elbow Surg 16:218–223

    Article  PubMed  Google Scholar 

  19. Leighton MM, Bush-Joseph CA, Bach BR (1995) Distal biceps brachii repair. Results in dominant and nondominant extremities. Clin Orthop Relat Res 317:114–121

    PubMed  Google Scholar 

  20. Mazzocca AD, Burton KJ, Romeo AA, Santangelo S, Adams DA, Arciero RA (2007) Biomechanical evaluation of 4 techniques of distal biceps brachii tendon repair. Am J Sports Med 35:252–258

    Article  PubMed  Google Scholar 

  21. Mazzocca AD, Spang JT, Arciero RA (2008) Distal biceps rupture. Orthop Clin North Am 39(2):237–249

    Article  PubMed  Google Scholar 

  22. Meherin JM, Kilgore ES Jr (1960) The treatment of ruptures of the distal biceps brachii tendon. Am J Surg 99:636–640

    Article  Google Scholar 

  23. Morrey BF, Askew LJ, An KN, Dobins JH (1985) Rupture of the distal tendon of the biceps brachii. A biomechanical study. J Bone Joint Surg 67A:418–421

    Google Scholar 

  24. Pereira D, Kvitne R, Liang M, Giacobetti FB, Ebramzadeh E (2002) Surgical repair of distal biceps tendon ruptures: a biomechanical comparison of two techniques. Am J Sports Med 30(3):432–436

    PubMed  Google Scholar 

  25. Perugia L, Postacchini F, Ippolito E (1986) The tendons. Masson ed, Milano

  26. Rantanen J, Orava S (1999) Rupture of the distal biceps tendon: a report of 19 patients treated with anatomic reinsertion, and a meta-analysis of 147 cases found in the literature. Am J Sports Med 27:128–132

    PubMed  CAS  Google Scholar 

  27. 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):149–156

    Article  PubMed  Google Scholar 

  28. Sotereanos DG, Pierce TD, Varitinidis SE (2000) A simplified method for repair of distal biceps tendon ruptures. J Shoulder Elbow Surg 9(3):227–233

    Article  PubMed  CAS  Google Scholar 

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De Carli, A., Zanzotto, E., Vadalà, A.P. et al. Surgical repair of the distal biceps brachii tendon: clinical and isokinetic long-term follow-up. Knee Surg Sports Traumatol Arthrosc 17, 850–856 (2009). https://doi.org/10.1007/s00167-008-0705-9

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  • DOI: https://doi.org/10.1007/s00167-008-0705-9

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