The Intramedullary Cortical Button Technique for Distal Biceps Tendon Repair

Abstract

The cortical button technique enables the surgeon to restore the distal biceps tendon anatomically to the posterior cortex of the radial tuberosity via single incision anterior approach. Providing high fixation strength it allows immediate postoperative rehabilitation and leads to excellent functional results. The button fixation technique requires a small 1-incision anterior approach without invasive exposure of the proximal radius. Nevertheless, it runs the risk of iatrogenic posterior interosseous nerve (PIN) injury. The blind deployment of the button on the cortical bone at the dorsal aspect of the radial tuberosity places the PIN at risk. The intramedullary cortical button technique represents a further development of the initial cortical button fixation. The button positioning inside the intramedullary canal enables the repair of the distal biceps tendon anatomical without perforating the posterior cortex and consequently not affecting the PIN.