Distal biceps tendon ruptures

Abstract

Rupture of the distal biceps brachii insertion is infrequent, representing only 3% of biceps muscle injuries. The mechanism of injury in distal rupture involves a strong contraction of the biceps tendon against unanticipated resistance. The injury is most common in the dominant arm of middle-aged men. Symptoms include weakness in elbow flexion (by 30%) and forearm supination (by 40%), often necessitating surgical repair in the working individual. There are two described surgical procedures for the repair of distal biceps ruptures with very good results. The modified Henry approach uses a single anterior incision, whereas the Boyd-Anderson technique involves a small anterior incision and a second posterolateral incision. Both of these techniques have been modified over time. A distal biceps tendon rupture is defined as chronic if it is greater than 4 weeks old. The results of surgical repair in chronic cases are less sufficient and the surgical technique is more demanding. Partial rupture cases are usually attritional and not associated with a traumatic event. Surgical treatment in refractory cases involves detachment of the biceps tendon, debridement, and reattachment. Distal biceps tendon ruptures repair is essential for laborers and athletic individuals who need normal strength for their activities of daily living or sport. Copyright © 2002 by the American Society for Surgery of the Hand