Réparation endoscopique des avulsions du biceps distal : une nouvelle technique. À propos de 25 cas

Abstract

Acute avulsion of the distal biceps brachii tendon requires urgent surgical reattachment. The usual open surgical techniques carry significant risks of local complications, mostly neurovascular injuries but also interosseous membrane synostosis. We have developed a mini-invasive method with endoscopic control, that is simple and reproducible, allowing anatomical repair of acute lesions using a suture anchor. This new technique was used in 23 consecutive patients (among them, 11 professional sportsmen), with a median age of 46 years, and a median postoperative follow-up of 26 months. In these 23 patients, 22 had satisfactory or very satisfactory outcomes, and 20 recovered their previous level at sport and professional activities after 6 months. There was a mean loss of 2,9 degrees in flexion and extension, of 8,6 degrees in pronation and 5 degrees in supination. Only one severe neurological complication requiring revision surgery was noted. Three other minor complications were reported: two cases of heterotopic ossification, and one transient radial nerve palsy. Compared to the techniques previously described in the scientific literature, our technique seems to be a simple, reproducible and secure method to repair recent avulsions of the distal biceps brachii tendon.