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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Azar FM, Loeb M (2003) Repair of acute distal biceps tendon ruptures. Oper Tech Sports Med 11:32–35
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
Bell RH, Wiley WB, Noble JS, Kuczynski DJ (2000) Repair of distal biceps brachii tendon ruptures. J Shoulder Elbow Surg 9:223–226
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
Boyd HB, Anderson LD (1961) A method of reinsertion of the distal biceps brachii tendon. J Bone Joint Surg 43A:1041–1043
Carroll RE, Hamilton LR (1967) Rupture of biceps brachii: a conservative method of treatment. J Bone Joint Surg 49A:1016
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
Davies GJ (1992) A compendium of isokinetics in clinical usage and rehabilitation techniques, 4th edn. S & S Publishers, Onasaka
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
Davison BL, Engber WD, Tigert LJ (1996) Long term evaluation of repaired distal biceps brachii tendon ruptures. Clin Orthop Relat Res 333:186–191
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
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
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
Gilcreest EL, Albi P (1939) Unusual lesions of muscles and tendons of the shoulder girdle and upper arm. Surg Gynecol Obstet 68:903–917
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
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
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
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
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
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
Mazzocca AD, Spang JT, Arciero RA (2008) Distal biceps rupture. Orthop Clin North Am 39(2):237–249
Meherin JM, Kilgore ES Jr (1960) The treatment of ruptures of the distal biceps brachii tendon. Am J Surg 99:636–640
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
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
Perugia L, Postacchini F, Ippolito E (1986) The tendons. Masson ed, Milano
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
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
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
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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