Abstract
Tears of the distal biceps are common, and nonoperative treatment results in significant loss of supination strength. Surgery is indicated for most patients to restore this supination strength. Both 1- and 2-incision techniques are successful, but each has its own advantages and disadvantages. We believe the 2-incision technique better restores the anatomic attachment site of the tendon, which leads to better supination strength and has a lower rate of neurologic injury. Although it does have a slightly higher risk of synostis, this can be mitigated by routine prophylaxis with NSAIDs. Augmenting the repair with a cortical button has been shown to increase the load-to-failure better than the traditional 2-incision technique that employs transosseous fixation. Here we present our technique of 2-incision distal biceps repair with cortical button, a technique intended to maximize supination strength.
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