Clinical, Functional, and Radiographic Assessments of the Conventional and Modified Boyd-Anderson Surgical Procedures for Repair of Distal Biceps Tendon Ruptures

1998 ◽  
Vol 26 (2) ◽  
pp. 254-261 ◽  
Author(s):  
Patrick D'Arco ◽  
Michael Sitler ◽  
John Kelly ◽  
Raymond Moyer ◽  
Paul Marchetto ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Elbow Flexion ◽  
Peak Torque ◽  
Clinical Results ◽  
Activity Levels ◽  
Distal Biceps Tendon ◽  
Radiographic Findings ◽  
Distal Biceps ◽  
Radiographic Outcomes ◽  
Tendon Ruptures

The purpose of this study was to evaluate the clinical, functional, and radiographic outcomes of the conventional and modified Boyd-Anderson procedures for repair of distal biceps tendon ruptures. Thirteen of 18 men who underwent surgical repair for unilateral distal biceps tendon ruptures at one university center participated in the study. In general, follow-up outcomes were favorable with respect to return to premorbid activity levels, patient satisfaction with surgical outcome, and overall clinical results. Elbow flexion, forearm supination, and upper extremity functional concentric peak torque and range of motion results were not significantly different between the surgical and nonsurgical arms when dominance was controlled as a confounding factor. Radiographic findings revealed no clinically remarkable signs of heterotopic ossification or proximal radioulnar synostosis. Results of the study reveal that the conventional and modified Boyd-Anderson procedures are clinically, functionally, and radio-graphically efficacious for repair of distal biceps tendon ruptures.

Repair of Distal Biceps Tendon Ruptures Using a Suture Anchor and an Anterior Approach

2004 ◽  
Vol 29 (2) ◽  
pp. 178-182 ◽  
Author(s):  
L. BALABAUD ◽  
C. RUIZ ◽  
J. NONNENMACHER ◽  
P. SEYNAEVE ◽  
P. KEHR ◽  
...  
Keyword(s):  
Anterior Approach ◽  
Suture Anchor ◽  
Single Incision ◽  
Biceps Tendon ◽  
Clinical Results ◽  
Distal Biceps Tendon ◽  
Isokinetic Testing ◽  
Distal Biceps ◽  
Tendon Ruptures ◽  
A Prospective Study

In a prospective study, eight consecutive patients with nine ruptures of the distal biceps tendon underwent repair through a single incision. All patients were satisfied with their clinical results and had full ranges of elbow and forearm motion. There were no radial nerve injuries and no radio-ulnar synostoses. Isokinetic testing, after correction for dominance, demonstrated a 6% strength deficit, but 7% higher endurance in the repaired extremity for the flexion-concentric test, and no strength deficit and 13% higher endurance for supination. The improved endurance is probably explained by initial reduced effort due to apprehension which minimized subsequent fatigue.

Acute distal biceps tendon ruptures: anatomy, pathology and management - state of the art

2020 ◽  
Vol 5 (5) ◽  
pp. 304-313
Author(s):  
Neil Kruger ◽  
Joideep Phadnis ◽  
Deepak Bhatia ◽  
Melanie Amarasooriya ◽  
Gregory Ian Bain
Keyword(s):  
Fatigue Strength ◽  
Biceps Tendon ◽  
Peak Torque ◽  
Alternative Methods ◽  
Distal Biceps Tendon ◽  
Training Centre ◽  
Distal Biceps ◽  
Anatomic Repair ◽  
Tendon Ruptures ◽  
Supination Strength

All patients with acute complete distal biceps tendon ruptures who are not low demand or medically unfit to proceed with surgery are offered operative repair. This restores arm shape, supination strength and function, and decreases their cramping symptoms. Surgical repair technique varies significantly depending on location and training centre. Nuances in technique and appropriate implant selection need to be noted in order to achieve a strong repair allowing early active range of motion. Intimate knowledge of distal biceps tendon anatomy is key to avoid complications associated with the different approaches. The cumulative body of evidence on complications, coupled with knowledge of the different biomechanical construct strengths of the alternative methods of fixation, points to the use of the cortical button technique without the addition of an interference screw. Subtle variations in drill hole positioning on the bicipital tuberosity secures either an anatomic or non-anatomic repair. Anatomic repair results in greater supination peak torque and fatigue strength, and in greater flexion fatigue strength. It is advisable to perform an anatomic repair in elite athletes or those patients who significantly rely on supination strength and endurance for their livelihood. A universal postoperative protocol is suggested for all repairs.

Reconstruction of Chronic Distal Biceps Tendon Rupture using Fascia Lata Autograft

2012 ◽  
Vol 2 (1) ◽  
pp. 55-59
Author(s):  
Nathan T Morrell ◽  
Deana M Mercer ◽  
Moheb S Moneim
Keyword(s):  
Tendon Rupture ◽  
Biceps Tendon ◽  
Donor Site ◽  
Elbow Flexion ◽  
Fascia Lata ◽  
Suture Anchors ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Biceps Tendon Rupture ◽  
Tendon Ruptures

ABSTRACT Introduction Distal biceps tendon ruptures are a rare injury and surgical reconstruction is typically recommended for chronic ruptures. There is no consensus regarding the most appropriate reconstruction technique. We present our experience with fascia lata autograft reconstructions of chronic distal biceps tendon ruptures using a modified single incision technique and distal fixation with suture anchors. Materials and methods We retrospectively reviewed the outcome of 12 male patients with chronic distal biceps tendon ruptures who had reconstruction using a fascia lata autograft through a single anterior approach. The age ranged from 29 to 62 years. The average delay to surgery was 26.5 weeks (range 6-68 weeks). A modified single anterior incision was utilized for all patients. Fascia lata autograft was attached distally to the bicipital tuberosity using suture anchors. Tension was set with the elbow in 50° of flexion. The average follow-up was 14.5 months (range 1.5-66 months). All patients were treated by the senior author (MSM). Results Eleven patients (92%) reported subjective improvement in elbow flexion and supination strength, as well as painless range of motion. The average elbow flexion/ extension arc was 126° (5° flexion to 131° flexion) and the average supination/pronation arc was 167 degrees (87° pronation to 80° supination). Five patients underwent isokinetic flexion strength testing which revealed a restoration of 86% of strength when compared to the uninvolved side. Four patients underwent supination isokinetic strength testing which revealed a restoration of 87% of strength when compared to uninvolved side. Four patients reported numbness in the superficial radial nerve distribution that recovered within 12 months. There were no cases of heterotopic ossification or graft rupture. There was one case of wound dehiscence at the elbow that required local flap coverage and went on to heal uneventfully. Aside from a small muscle bulge at the donor site, there were no donor site complications. Conclusion To our knowledge, this is the largest case series of patients undergoing distal biceps tendon reconstruction using fascia lata autograft. Our study has demonstrated a low complication rate with functional results similar to those reported in the literature utilizing a similar technique. We conclude that this technique offers a surgical treatment alternative that yields satisfactory functional outcomes with a low risk of complication. Morrell NT, Mercer DM, Moneim MS. Reconstruction of Chronic Distal Biceps Tendon Rupture using Fascia Lata Autograft. The Duke Orthop J 2012;2(1):55-59.

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.

Repair of Distal Biceps Tendon Ruptures Using Suture Anchors Through a Single Anterior Incision

2008 ◽  
Vol 24 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Abdul D. Khan ◽  
Sri Penna ◽  
Qi Yin ◽  
Chris Sinopidis ◽  
Peter Brownson ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Suture Anchors ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Tendon Ruptures ◽  
Anterior Incision

scholarly journals Gouty Tenosynovitis of the Distal Biceps Tendon Insertion Complicated by Partial Rupture

Hand ◽  
2016 ◽  
Vol 12 (1) ◽  
pp. NP1-NP5 ◽  
Author(s):  
Rick J. Fairhurst ◽  
Arnold M. Schwartz ◽  
Leo M. Rozmaryn
Keyword(s):  
Tendon Rupture ◽  
Biceps Tendon ◽  
Partial Rupture ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
First Case ◽  
Biceps Tendon Rupture ◽  
History Of ◽  
Tendon Ruptures ◽  
Tendon Insertion

Background: Given the appreciable prevalence of gout, gout-induced tendon ruptures in the upper extremity are extremely rare. Although these events have been reported only 5 times in the literature, all in patients with a risk factor for or history of gout, they have conspicuously never been diagnosed in the shoulder or elbow. Methods: A 45-year-old, right-hand-dominant man with a history of gout presented with pain in his right anterior elbow and weakness in his forearm after a trivial injury. Results: Here, we report the first case of gouty tenosynovitis of the distal biceps tendon insertion complicated by partial rupture, a composite diagnosis supported by both intraoperative and histological observations. Conclusions: In patients who are clinically diagnosed with biceps tendon rupture and have a history of gout, it is important to consider the possibility of a gout-related pathological manifestation causing or simulating tendon rupture.

Endoscopic-Assisted Footprint Repair of Distal Biceps Tendon Ruptures

2021 ◽  
pp. 453-457
Author(s):  
Mina Derias ◽  
Gregory I. Bain ◽  
Joideep Phadnis
Keyword(s):  
Biceps Tendon ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Tendon Ruptures

Primary repair of retracted distal biceps tendon ruptures in extreme flexion

2014 ◽  
Vol 23 (5) ◽  
pp. 679-685 ◽  
Author(s):  
Mark E. Morrey ◽  
Matthew P. Abdel ◽  
Joaquin Sanchez-Sotelo ◽  
Bernard F. Morrey
Keyword(s):  
Primary Repair ◽  
Biceps Tendon ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Tendon Ruptures
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