Abstract
Historically, both anterior and posterior approaches have been described for distal biceps tendon repair. In an effort to minimize heterotopic ossification and avoid a second incision with splitting of the supinator muscle, the anterior approach has gained popularity. The anterior approach takes advantage of the internervous plane between the brachioradialis and the pronator teres, avoiding damage to the musculature. While multiple fixation methods have been described, we advocate the use of a cortical button using the tension-slide technique and an interference screw, which has been shown to be biomechanically superior. The interference screw directs the tendon posteriorly for a more anatomic repair. Differences in clinical outcomes and major complications have not been shown between surgical approaches or fixation types. A higher rate of lateral antebrachial cutaneous nerve palsy has been reported with the anterior approach, which we believe is technique related and can be decreased by using rounded-edge direct-pull retractors. Overall, good to excellent clinical results can be expected following biceps tendon repair.
Published Version
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