Top

Published in:

Open Access 01-12-2022 | Research

Distal biceps tendon ruptures occur with the almost extended elbow and supinated forearm – an online video analytic study

Authors: Sebastian Lappen, Sebastian Siebenlist, Pavel Kadantsev, Maximilian Hinz, Jesse Seilern und Aspang, Patricia M. Lutz, Andreas B. Imhoff, Stephanie Geyer

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Abstract

Background

Distal biceps tendon ruptures can lead to significant restrictions in affected patients. The mechanisms of injury described in scientific literature are based exclusively on case reports and theoretical models. This study aimed to determine the position of the upper extremities and forces involved in tendon rupture through analyzing video recordings.

Methods

The public YouTube.com database was queried for videos capturing a clear view of a distal biceps tendon rupture. Two orthopedic surgeons independently assessed the videos for the activity that led to the rupture, the arm position at the time of injury and the forces imposed on the elbow joint.

Results

Fifty-six video segments of a distal biceps rupture were included (55 male). In 96.4%, the distal biceps tendon ruptured with the forearm supinated and the elbow isometrically extended (non-dynamic muscle engagement) (71.4%) or slightly flexed (24%). The most common shoulder positions were adduction (85.7%) and neutral position with respect to rotation (92.9%). Most frequently a tensile force was enacted on the elbow (92.9%) and the most common activity observed was deadlifting (71.4%).

Conclusion

Distal biceps tendon ruptures were most commonly observed in weightlifting with a slightly flexed or isometrically extended elbow and forearm supination. These observations may provide useful information for sports specific evidence-based injury prevention, particularly in high performing athletes and individuals engaged in resistance training.

Level of evidence

Observational study.

Kelly MP, Perkinson SG, Ablove RH, Tueting JL. Distal Biceps Tendon Ruptures: An Epidemiological Analysis Using a Large Population Database. Am J Sports Med. 2015;43(8):2012–7. https://doi.org/10.1177/0363546515587738.CrossRefPubMed

Anzel SH, Covey KW, Weiner AD, Lipscomb PR. Disruption of muscles and tendons; an analysis of 1, 014 cases. Surgery. 1959;45(3):406–14.PubMed

Morrey BF, Askew LJ, An KN, Dobyns JH. Rupture of the distal tendon of the biceps brachii A biomechanical study. J Bone Joint Surg American Volume. 1985;67(3):418–21.CrossRef

Safran MR, Graham SM. Distal biceps tendon ruptures: incidence, demographics, and the effect of smoking. Clin Orthop Relat Res. 2002;404:275–83.CrossRef

Pagonis T, Givissis P, Ditsios K, Pagonis A, Petsatodis G, Christodoulou A. The effect of steroid-abuse on anatomic reinsertion of ruptured distal biceps brachii tendon. Injury. 2011;42(11):1307–12. https://doi.org/10.1016/j.injury.2011.03.018.CrossRefPubMed

Wentzell M. Post-operative rehabilitation of a distal biceps brachii tendon reattachment in a weightlifter: a case report. J Can Chiropr Assoc. 2018;62(3):193–201.PubMedPubMedCentral

Donaldson O, Vannet N, Gosens T, Kulkarni R. Tendinopathies Around the Elbow Part 2: Medial Elbow, Distal Biceps and Triceps Tendinopathies. Should Elb. 2014;6(1):47–56. https://doi.org/10.1111/sae.12022.CrossRef

Storti TM, Paniago AF, Faria RS. Simultaneous bilateral distal biceps tendon repair: case report. Revista brasileira de ortopedia. 2016;52(1):107–10. https://doi.org/10.1016/j.rboe.2016.12.006.CrossRefPubMedPubMedCentral

Ding DY, LaMartina JA 2nd, Zhang AL, Pandya NK. Acute distal biceps rupture in an adolescent weightlifter on chronic steroid suppression: a case report. J Pediatr Orthop B. 2016;25(5):447–9. https://doi.org/10.1097/BPB.0000000000000328.CrossRefPubMed

10.

George M. S. (2010). Simultaneous acute rotator cuff tear and distal biceps rupture in a strongman competitor. Orthopedics, 33(4), https://doi.org/10.3928/01477447-20100225-28. https://doi.org/10.3928/01477447-20100225-28.

11.

Shukla DR, Morrey BF, Thoreson AR, An KN, O’Driscoll SW. Distal biceps tendon rupture: an in vitro study. Clin Biomech (Bristol, Avon). 2012;27(3):263–7. https://doi.org/10.1016/j.clinbiomech.2011.09.010.CrossRef

12.

Grassi A, Smiley SP, Roberti di Sarsina T, Signorelli C, Marcheggiani Muccioli GM, Bondi A, Romagnoli M, Agostini A, Zaffagnini S. Mechanisms and situations of anterior cruciate ligament injuries in professional male soccer players: a YouTube-based video analysis. Eur J Orthop Surg Traumatol. 2017;27(7):967–81. https://doi.org/10.1007/s00590-017-1905-0.CrossRefPubMed

13.

Kwon JY, Chacko AT, Kadzielski JJ, Appleton PT, Rodriguez EK. A novel methodology for the study of injury mechanism: ankle fracture analysis using injury videos posted on YouTube.com. J Orthop Trauma. 2010;24(8):477–82. https://doi.org/10.1097/BOT.0b013e3181c99264.CrossRefPubMed

14.

Schreiber JJ, Warren RF, Hotchkiss RN, Daluiski A. An online video investigation into the mechanism of elbow dislocation. J Hand Surg. 2013;38(3):488–94. https://doi.org/10.1016/j.jhsa.2012.12.017.CrossRef

15.

Oomman A, Sarwar U, Javed M, Hemington-Gorse S. YouTube as a potential online source of information in the prevention and management of paediatric burn injuries. Burns : J Int Soc Burn Injuries. 2013;39(8):1652. https://doi.org/10.1016/j.burns.2013.06.012.CrossRef

16.

Moran K. Jumping to (fatal) conclusions? An analysis of video film on a social networking web site of recreational jumping from height into water. Int J Inj Contr Saf Promot. 2014;21(1):47–53. https://doi.org/10.1080/17457300.2012.755207.CrossRefPubMed

17.

Williams D, Sullivan SJ, Schneiders AG, Ahmed OH, Lee H, Balasundaram AP, McCrory PR. Big hits on the small screen: an evaluation of concussion-related videos on YouTube. Br J Sports Med. 2014;48(2):107–11. https://doi.org/10.1136/bjsports-2012-091853.CrossRefPubMed

18.

Seiler JG 3rd, Parker LM, Chamberland PD, Sherbourne GM, Carpenter WA. The distal biceps tendon Two potential mechanisms involved in its rupture: arterial supply and mechanical impingement. J Shoulder Elbow Surg. 1995;4(3):149–56. https://doi.org/10.1016/s1058-2746(05)80044-8.CrossRefPubMed

19.

Ramsey ML. Distal biceps tendon injuries: diagnosis and management. J Am Acad Orthop Surg. 1999;7(3):199–207. https://doi.org/10.5435/00124635-199905000-00006.CrossRefPubMed

20.

Rausch V, Krieter JP, Leschinger T, Hackl M, Scaal M, Müller LP, Wegmann K. The Radioulnar Distance at the Level of the Radial Tuberosity. Clin Anatomy (New York, NY). 2020;33(5):661–6. https://doi.org/10.1002/ca.23483.CrossRef

21.

Andersen TE, Larsen Ø, Tenga A, Engebretsen L, Bahr R. Football incident analysis: a new video based method to describe injury mechanisms in professional football. Br J Sports Med. 2003;37(3):226–32. https://doi.org/10.1136/bjsm.37.3.226.CrossRefPubMedPubMedCentral

Title: Distal biceps tendon ruptures occur with the almost extended elbow and supinated forearm – an online video analytic study
Authors: Sebastian Lappen
Sebastian Siebenlist
Pavel Kadantsev
Maximilian Hinz
Jesse Seilern und Aspang
Patricia M. Lutz
Andreas B. Imhoff
Stephanie Geyer
Publication date: 01-12-2022
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-022-05546-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Distal biceps tendon ruptures occur with the almost extended elbow and supinated forearm – an online video analytic study

Abstract

Background

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Level of evidence

Please log in to get access to this content

Other articles of this Issue 1/2022

Effectiveness of combined extracorporeal shock-wave therapy and hyaluronic acid injections for patients with shoulder pain due to rotator cuff tendinopathy: a person-centered approach with a focus on gender differences to treatment response

Categorize the existing clamps used for tensile test of human graft– a systematic review

Ultrasonographic assessment of entheseal sites of upper and lower extremities in hemodialysis patients using Madrid Sonography Enthesitis Index

Tranexamic acid in pertrochanteric fractures: a retrospective analysis of perioperative outcomes after fixation with a proximal femoral nail

Prevalence and factors associated with postpartum pelvic girdle pain among women in Poland: a prospective, observational study

T2 mapping and fat quantification of lumbar paraspinal muscle in ankylosing spondylitis: a case control study