Single incision repair of acute distal biceps ruptures using suture anchors (SS-99)

Abstract

Distal biceps tendon tears occur relatively uncommonly, and controversy exists over the best choice of technique for their repair. The purpose of this study is to report the results of a single limited-incision technique for repair of acute distal biceps ruptures using suture anchors. Sixty consecutive patients underwent distal biceps repair following an acute rupture (less than 6 weeks) utilizing a limited antecubital incision and suture anchors between January 1997 and January 2001. Fifty-three of these patients could be evaluated at an average follow-up of 25 months (range: 12 months to 3 years, 11 months). The procedure consisted of a limited transverse incision made in the antecubital fossa. The retracted biceps tendon end was identified, retrieved and lightly debrided. Two suture anchors were placed in the radial tuberosity, and the tendon was re-approximated. Based on the intraoperative tension on the repair, range of motion was started early, at two to four weeks. The average age of the 50 males and 3 females was 46 years. Final follow-up consisted of physical examination, radiographs and Andrews-Carson elbow score tabulations. Also, 16 patients underwent Cybex isokinetic testing. According to the Andrews-Carson scores, there were forty-six excellent results and seven good outcomes with no fair or poor results. Cybex testing demonstrated a decrease in elbow flexion (5%) and supination strength (7%) compared to the contralateral extremity, but these were not statistically significant. Two patients developed heterotopic ossification that resulted in mild losses of forearm rotation and mild pain. Also, one patient developed a temporary radial nerve palsy that completely recovered within 8 weeks. Repair of acute distal biceps tears utilizing a limited antecubital incision and suture anchors is an effective technique. Distal biceps tendon tears occur relatively uncommonly, and controversy exists over the best choice of technique for their repair. The purpose of this study is to report the results of a single limited-incision technique for repair of acute distal biceps ruptures using suture anchors. Sixty consecutive patients underwent distal biceps repair following an acute rupture (less than 6 weeks) utilizing a limited antecubital incision and suture anchors between January 1997 and January 2001. Fifty-three of these patients could be evaluated at an average follow-up of 25 months (range: 12 months to 3 years, 11 months). The procedure consisted of a limited transverse incision made in the antecubital fossa. The retracted biceps tendon end was identified, retrieved and lightly debrided. Two suture anchors were placed in the radial tuberosity, and the tendon was re-approximated. Based on the intraoperative tension on the repair, range of motion was started early, at two to four weeks. The average age of the 50 males and 3 females was 46 years. Final follow-up consisted of physical examination, radiographs and Andrews-Carson elbow score tabulations. Also, 16 patients underwent Cybex isokinetic testing. According to the Andrews-Carson scores, there were forty-six excellent results and seven good outcomes with no fair or poor results. Cybex testing demonstrated a decrease in elbow flexion (5%) and supination strength (7%) compared to the contralateral extremity, but these were not statistically significant. Two patients developed heterotopic ossification that resulted in mild losses of forearm rotation and mild pain. Also, one patient developed a temporary radial nerve palsy that completely recovered within 8 weeks. Repair of acute distal biceps tears utilizing a limited antecubital incision and suture anchors is an effective technique.