scholarly journals Greater radial tuberosity size is associated with distal biceps tendon rupture: a quantitative 3-D CT case–control study

2021 ◽  
Author(s):  
Nick F. J. Hilgersom ◽  
Myrthe Nagel ◽  
Stein J. Janssen ◽  
Izaäk F. Kodde ◽  
Bertram The ◽  
...  
Keyword(s):  
Tendon Rupture ◽  
Biceps Tendon ◽  
Control Group ◽  
Maximum Height ◽  
Distal Biceps Tendon ◽  
3 Dimensional ◽  
Distal Biceps ◽  
Distal Biceps Tendon Rupture ◽  
Biceps Tendon Rupture ◽  
Radial Tuberosity

Abstract Purpose During pronation, the distal biceps tendon and radial tuberosity internally rotate into the radioulnar space, reducing the linear distance between the radius and ulna by approximately 50%. This leaves a small space for the distal biceps tendon to move in and could possibly cause mechanical impingement or rubbing of the distal biceps tendon. Hypertrophy of the radial tuberosity potentially increases the risk of mechanical impingement of the distal biceps tendon. The purpose of our study was to determine if radial tuberosity size is associated with rupturing of the distal biceps tendon. Methods Nine patients with a distal biceps tendon rupture who underwent CT were matched 1:2 to controls without distal biceps pathology. A quantitative 3-dimensional CT technique was used to calculate the following radial tuberosity characteristics: 1) volume in mm3, 2) surface area in mm2, 3) maximum height in mm and 4) location (distance in mm from the articular surface of the radial head). Results Analysis of the 3-dimensional radial tuberosity CT-models showed larger radial tuberosity volume and maximum height in the distal biceps tendon rupture group compared to the control group. Mean radial tuberosity volume in the rupture-group was 705 mm3 (SD: 222 mm3) compared to 541 mm3 (SD: 184 mm3) in the control group (p = 0.033). Mean radial tuberosity maximum height in the rupture-group was 4.6 mm (SD: 0.9 mm) compared to 3.7 mm (SD: 1.1 mm) in the control group, respectively (p = 0.011). There was no statistically significant difference in radial tuberosity surface area (ns) and radial tuberosity location (ns). Conclusion Radial tuberosity volume and maximum height were significantly greater in patients with distal biceps tendon ruptures compared to matched controls without distal biceps tendon pathology. This supports the theory that hypertrophy of the radial tuberosity plays a role in developing distal biceps tendon pathology. Level of evidence Level III.

scholarly journals The Size of the Radial Tuberosity is Not Related to the Occurrence of Distal Biceps Tendon Ruptures: A Case-Control Study

2016 ◽  
Vol 10 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Izaäk F. Kodde ◽  
Michel P.J. van den Bekerom ◽  
Paul G.H. Mulder ◽  
Denise Eygendaal
Keyword(s):  
Tendon Rupture ◽  
Biceps Tendon ◽  
Maximum Diameter ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Distal Biceps Tendon Rupture ◽  
Biceps Tendon Rupture ◽  
Tendon Ruptures ◽  
The Mean ◽  
Radial Tuberosity

Introduction: Hypertrophic changes at the radial tuberosity have traditionally been related to distal biceps tendon degeneration and rupture. From supination to pronation of the forearm, the space available for the distal biceps tendon between de lateral ulna and radial bicipital tuberosity (RBT) decreases by almost 50%. A hypertrophic change at the radial tuberosity further reduces this space with impingement of the distal biceps tendon as a result. The purpose of this study was to evaluate whether the size of the RBT plays a role in the pathophysiology of distal biceps tendon ruptures. Materials and Methods: Twenty-two consecutive patients with a surgically proven distal biceps tendon rupture were matched to controls, in a 1:1 ratio. The size of the RBT was expressed as a ratio of the maximum diameter of the radius at the RBT to the diameter of the diaphysis just distal to the RBT (RD ratio), measured on standard radiographs of the elbow. The RD ratio of patients and matched controls were compared. Results: The mean RD ratio in control group was 1.25 and not significantly different from the mean 1.30 in the group of patients with a distal biceps tendon rupture. Each 0.1 point increase in RD ratio results in an estimated 60% increase of the rupture odds, which was not significant either. Conclusion: Based on the RD ratio on conventional radiographs of the elbow, there was no significant difference in RBT size between patients with a distal biceps tendon rupture and matched controls without biceps tendon pathology.

scholarly journals Reconstruction with interference screw of ruptured distal biceps brachii tendon at level of insertion into radial tuberosity: a case report

2020 ◽  
Vol 8 (3) ◽  
pp. 1163
Author(s):  
Gusti Ngurah Putra Stanu ◽  
I. Gusti Ngurah Wien Aryana ◽  
Ivander Purvance ◽  
Ni Made Puspa Dewi Astawa
Keyword(s):  
Tendon Rupture ◽  
Biceps Brachii ◽  
Biceps Tendon ◽  
Distal Biceps Tendon ◽  
Rare Injury ◽  
Distal Biceps ◽  
Left Elbow ◽  
Distal Biceps Tendon Rupture ◽  
Biceps Tendon Rupture ◽  
Radial Tuberosity

Distal biceps tendon rupture is a relatively rare injury. The incidence of distal biceps rupture is 1.2 cases per 100,000 patients per year, with the average age is 47 years old and the majority is male patient with dominant extremity. A 43 years old male presented with pain of the left elbow and weakness to flex and supinate the forearm following gymnastic activity. He heard pop sound on his left elbow during lifting dumbbell and followed by a sudden pain on his arm and weakness to flex and supinate the elbow. The USG examination were performed and confirmed there was a rupture on the distal biceps tendon at the level of insertion. Durante operation confirmed a complete rupture of distal biceps tendon. A Henry approach incision is performed to expose radial tuberosity, and the ruptured tendon was reconstructed by anchored into the tuberosity of radius with bioabsorbable screw. After closing the incision, patient is immobilized by cast in 60 to 90o elbow flexion and neutral pronosupination. Distal biceps tendon rupture can be successfully repaired by single anterior approach using anatomical anchor on radial tuberosity, so that can avoid posterior approach and associated proximal radioulnar synostosis risk while conserving interosseous membrane.

Distal biceps tendon rupture

2004 ◽  
Vol 14 (3) ◽  
Author(s):  
OlgaD. Savvidou ◽  
PanayiotisJ. Papagelopoulos ◽  
AndreasF. Mavrogenis ◽  
AntoniosA. Partsinevelos ◽  
EvangelosJ. Karadimas ◽  
...  
Keyword(s):  
Tendon Rupture ◽  
Biceps Tendon ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Distal Biceps Tendon Rupture ◽  
Biceps Tendon Rupture

scholarly journals Acute distal biceps tendon rupture: retrospective analysis of two different approaches and fixation techniques

2021 ◽  
Author(s):  
Marco Di Stefano ◽  
Lorenzo Sensi ◽  
Leonardo di Bella ◽  
Raffaele Tucci ◽  
Efisio Bazzucchi ◽  
...  
Keyword(s):  
Tendon Rupture ◽  
Biceps Tendon ◽  
Dash Score ◽  
Complication Rates ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Distal Biceps Tendon Rupture ◽  
Biceps Tendon Rupture ◽  
Significant Difference ◽  
Flexion Extension

Abstract Purpose The aim of our study is to compare the modified double incision (DI) with bone tunnel reinsertion with the single-incision (SI) double tension slide technique in terms of clinical and functional outcomes and complication rates. Methods A retrospective comparative analysis was performed on 65 patients treated for total distal biceps tendon rupture. The surgical technique adopted for each patient was based on the preference of two experienced elbow surgeons. The DASH and MAYO questionnaires, functional outcome and ROM were recorded in all subjects. Results Of 65 patients, we collected data of a cohort of 54 distal biceps tendon ruptures that satisfied inclusion criteria. Twenty-five were treated by modified DI and 29 SI techniques. The recovery of the complete ROM in terms of flexion/extension and prono-supination occurred in the 79.6% of the patients, without statistical significant difference between the adopted technique. We reported a complication rate of 12% and 20.7% for DI and SI techniques, respectively, without statistical correlation (P = 0.84). The average DASH score was similar for DI and SI techniques without significant differences (P = 0,848). The Mayo score results were excellent in the majority of the patients. No significant difference in MAYO results was reported comparing the surgical techniques (P = 1). Conclusion Both techniques provide a reliable and strong repair with an optimal recovery of ROM returning to preinjury activity with substantially overlapping timelines.

BET 1: Best Evidence Topic Report: is the hook test sensitive enough to be used to exclude distal biceps tendon rupture?

2020 ◽  
Vol 38 (1) ◽  
pp. 78.2-79
Author(s):  
David Annison ◽  
James McVie
Keyword(s):  
Upper Limb ◽  
Tendon Rupture ◽  
Biceps Tendon ◽  
Clinical Question ◽  
Single Test ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Distal Biceps Tendon Rupture ◽  
Biceps Tendon Rupture ◽  
Study Type

A shortcut review was carried out to see whether the hook test is sensitive enough for a negative result to exclude complete distal biceps tendon rupture (DBTR) in adults. 3 papers presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that the hook test is moderately sensitive at detecting complete DBTR when carried out by skilled clinicians in specialist upper limb clinics. As a single test, it is not sensitive enough to be used to exclude complete DBTR.

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