Single Incision Modified Tension Slide Technique in Distal Biceps Repair

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Michael J. Fitzgerald ◽  
James R. Mullen ◽  
Mikael J. Starecki ◽  
Andrew Greenberg ◽  
David V. Tuckman
Keyword(s):  
Single Incision ◽  
Distal Biceps ◽  
Distal Biceps Repair ◽  
Slide Technique

scholarly journals Single Incision Distal Biceps Repair With Hemi-Krackow Suture Technique

Hand ◽  
2016 ◽  
Vol 11 (2) ◽  
pp. 238-244
Author(s):  
Peter Goljan ◽  
Nimit Patel ◽  
Justin D. Stull ◽  
Brandon P. Donnelly ◽  
Randall W. Culp
Keyword(s):  
Single Incision ◽  
Suture Technique ◽  
Distal Biceps ◽  
Distal Biceps Repair ◽  
Krackow Suture

scholarly journals Distal Biceps Tendon Repair Using A Single-incision Approach With Unicortical Intramedullary Button Fixation: Report Early Post-operative Outcomes And Complications

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0036
Author(s):  
Kenneth M. Lin ◽  
Justin Chan ◽  
Brian J. Lin ◽  
Christopher L. Camp ◽  
Grant Hoerig Garcia ◽  
...  
Keyword(s):  
Heterotopic Ossification ◽  
Single Incision ◽  
Biceps Tendon ◽  
Tendon Repair ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Distal Biceps Repair ◽  
Cortical Button ◽  
Biceps Tendon Repair

Objectives: While various techniques for distal biceps repair have been described, biomechanical studies have shown cortical button fixation to outperform bone tunnels, intraosseous screws, and suture anchors. Furthermore, numerous studies have shown no difference in complication rate between single- and dual-incision approaches. Thus, it follows that a single-incision approach with cortical button fixation may provide superior clinical outcomes with minimal complications. The purpose of this study is first to investigate intra-operative and short-term complications of distal biceps tendon repair through a single-incision approach using unicortical button fixation, and secondly to assess clinical outcomes. Methods: 52 patients who underwent distal biceps repair with unicortical button fixation (Figure 1) at a single institution from 2014 to 2017 were identified. Exclusion criteria included age less than 18 or greater than 75 years, prior ipsilateral biceps repair, concomitant ipsilateral surgical procedure, and most recent follow-up less than 2 months. Postoperative nerve deficits, flexion and supination strength by manual testing, range of motion, Mayo Elbow Performance Score (MEPS) and radiographs for identification of heterotopic ossification (HO) were obtained and analyzed retrospectively. Results: Fifty-two patients with 53 distal biceps ruptures were included, with mean age 48 years (range 25-71 years). Median time from injury to surgery was 2 weeks (range 1 day to 16 weeks), with 15 patients being treated at greater than 3 weeks from injury. Forty-four patients (83%) had complete tears. Following surgery, average time to final follow-up was 22.8 weeks (range 8-65 weeks). Postoperatively, 49 patients (92.5%) had full range of motion, 48 patients (90.6%) had return of full supination and flexion strength by manual muscle testing (the remaining patients had strength graded as 5-/5). There was no difference in outcomes between those patients treated < 3 weeks from injury compared to those treated > 3 weeks from injury. Two patients (3.8%) initially reported sensory deficit in the lateral antebrachial cutaneous nerve distribution, both cases of which fully resolved by 7 and 11 weeks postoperative. Two patients (3.8%) displayed radiographic evidence of heterotopic ossification, Hastings and Graham class I (Figure 2). One of these was an incidental finding without any clinical symptoms, the other had mild pain but normal strength and neurovascular function. Mean postoperative MEPS was 93.9 (range 60-100), corresponding to “excellent” function (MEPS>90). Conclusion: Distal biceps repair using single incision, unicortical button fixation yields a low rate of complications with good clinical results compared to other techniques reported in the literature. The single incision approach in patients treated between 3 and 16 weeks from injury is safe and resulted in outcomes no different than in those patients treated <3 weeks from injury. Further investigation is warranted in the form of larger, comparative studies with more robust outcome measures and longer term follow up. [Figure: see text][Figure: see text]

scholarly journals How to Avoid Posterior Interosseous Nerve Injury During Single-Incision Distal Biceps Repair Drilling

2019 ◽  
Vol 477 (2) ◽  
pp. 424-431 ◽  
Author(s):  
David Becker ◽  
Francisco Antonio Lopez-Marambio ◽  
Niels Hammer ◽  
David Kieser
Keyword(s):  
Nerve Injury ◽  
Single Incision ◽  
Posterior Interosseous Nerve ◽  
Distal Biceps ◽  
Distal Biceps Repair

Biomechanical analysis suggests early rehabilitation is possible after single-incision EndoButton distal biceps repair with FiberWire

2010 ◽  
Vol 19 (6) ◽  
pp. 1019-1022 ◽  
Author(s):  
David M. Rose ◽  
Jason D. Archibald ◽  
Edward G. Sutter ◽  
Stephen M. Belkoff ◽  
John H. Wilckens
Keyword(s):  
Single Incision ◽  
Early Rehabilitation ◽  
Biomechanical Analysis ◽  
Distal Biceps ◽  
Distal Biceps Repair

A Single-Incision Technique for Distal Biceps Repair Using a Flexible Reamer

Orthopedics ◽  
2017 ◽  
Vol 40 (4) ◽  
pp. e744-e748
Author(s):  
Todd P. Pierce ◽  
Casey M. Pierce ◽  
Kimona Issa ◽  
Vincent K. McInerney ◽  
Anthony Festa ◽  
...  
Keyword(s):  
Single Incision ◽  
Distal Biceps ◽  
Distal Biceps Repair ◽  
Incision Technique

scholarly journals Clinical Outcomes After Revision Distal Biceps Tendon Surgery

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712098175
Author(s):  
Gagan Grewal ◽  
Eamon D. Bernardoni ◽  
Mark S. Cohen ◽  
John J. Fernandez ◽  
Nikhil N. Verma ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Revision Surgery ◽  
Single Incision ◽  
Biceps Tendon ◽  
Tendon Repair ◽  
Common Finding ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Distal Biceps Repair ◽  
Biceps Tendon Repair

Background: Little is known about the clinical indications of performing a revision distal biceps tendon repair/reconstruction, and there is even less data available on the clinical outcomes of patients after revision surgery. Purpose: To determine the clinical outcomes of patients undergoing revision distal biceps tendon repair/reconstruction and evaluate the causes of primary repair failure. Study Design: Case series; Level of evidence, 4. Methods: We performed a retrospective review of patients undergoing ipsilateral primary and revision distal biceps tendon repair/reconstruction at a single institution. Between 2011 and 2016, a total of 277 patients underwent distal biceps tendon repair, with 8 patients requiring revision surgery. Patient characteristics, surgical technique, and patient-reported outcome scores (shortened version of Disabilities of Arm, Shoulder and Hand [QuickDASH], 12-Item Short Form Health Survey [SF-12], visual analog scale [VAS] for pain, and Mayo Elbow Performance Score [MEPS]), were assessed. Complications as well as indications for reoperation after primary and revision surgery were examined. Results: The overall revision rate was 2.9%. The number of single- and double-incision techniques utilized were similar among the primary repairs (50% single-incision, 50% double-incision) and revision repairs/reconstructions (62.5% single-incision, 37.5% double-incision). Reasons for reoperation included continued pain and weakness (n = 7), limited range of motion (n = 2), and acute traumatic re-rupture (n = 1). The median duration between primary and revision surgery was 9.5 months (interquartile range [IQR], 5.8-12.8 months). Intraoperatively, the most common finding during revision was a partially ruptured, fibrotic distal tendon with extensive adhesions. At a median of 33.7 months after revision surgery (IQR, 21.7-40.7 months), the median QuickDASH was 12.5 (IQR, 1.7-23.3), MEPS was 92.5 (IQR, 80.0-100), SF-12 mental component measure was 53.4 (IQR, 47.6-58.2), SF-12 physical component measure was 52.1 (IQR, 36.9-55.4), and VAS for elbow pain was 1.0 (IQR, 0-2.0). Revision surgery had a complication rate of 37.5% (3 of 8 patients), consisting of persistent pain and weakness (2 patients; 25%) and numbness over the dorsal radial sensory nerve (1 patient; 12.5%). Two patients required reoperation (25% reoperation rate). Conclusion: The overall revision distal biceps repair/reconstruction rate was approximately 3%. While patients undergoing revision distal biceps repair demonstrated improved outcomes after revision surgery, these outcomes remained inferior to previously reported outcomes of patients undergoing only primary distal biceps repair.

Single incision power optimizing cost-effective (SPOC) distal biceps repair

2013 ◽  
Vol 22 (3) ◽  
pp. 305-311 ◽  
Author(s):  
Cary Tanner ◽  
Toby Johnson ◽  
Pavel Muradov ◽  
Lisa Husak
Keyword(s):  
Single Incision ◽  
Cost Effective ◽  
Distal Biceps ◽  
Distal Biceps Repair

scholarly journals Return of an Intact Hook Test Result: Clinical Assessment of Biceps Tendon Integrity After Surgical Repair

2019 ◽  
Vol 7 (2) ◽  
pp. 232596711982731 ◽  
Author(s):  
Graham D. Pallante ◽  
Shawn W. O’Driscoll
Keyword(s):  
Surgical Repair ◽  
Biceps Tendon ◽  
Distal Biceps Tendon ◽  
Level Of Evidence ◽  
Distal Biceps ◽  
Effective Manner ◽  
Distal Biceps Repair ◽  
Tendon Ruptures ◽  
Test Result

Background: The hook test is a sensitive and specific tool that has been previously described for diagnosing distal biceps tendon ruptures in an efficient, cost-effective manner. However, its application in postoperative evaluations after surgical repair of distal biceps tendon ruptures is not documented. Hypothesis/Purpose: We hypothesized that the hook test result returns to normal at some point postoperatively after distal biceps repair. This information could be used in decision making during follow-up examinations with both normal and abnormal findings. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: We retrospectively reviewed records of distal biceps repair. Between July 1, 2003, and July 1, 2016, a total of 56 patients underwent distal biceps repair and also had clear documentation of the results of the hook test during the postoperative period. Hook test results consisted of “intact,” “abnormal,” or “absent.” The timing of the return to a normal hook test result was recorded. Results: Overall, 51 of 57 (89%) repairs were documented to have the hook test result return to “intact.” The test result returned to intact by a mean of 10 weeks after surgery (range, 2 weeks to 15 months). The biceps tendon was intact according to the hook test at the 4-month follow-up in 45 of the 51 patients (88%) in whom it ultimately returned. The hook test result was abnormal in 5 repairs in 5 patients with only a short-term follow-up, ranging from 2 to 7 weeks postoperatively. One patient with an abnormal hook test result at 2 weeks postoperatively underwent revision and was confirmed to have a partial tear of the biceps insertion. His hook test result returned to intact 3 months after revision repair. Conclusion: The hook test result returns to normal in patients who undergo distal biceps repair in the primary and revision settings with adequate follow-up. The vast majority of patients have a normal hook test result by 4 months postoperatively. An abnormal hook test result at 4 months postoperatively may indicate a failed repair and should prompt further investigation.

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