Reattachment of an avulsed distal biceps tendon in athletes

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.