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Repair of the torn distal biceps tendon by endobutton fixation

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Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Background: A number of techniques have been described to reattach the torn distal biceps tendon to the bicipital tuberosity. We report a retrospective analysis of single incision technique using an endobutton fixation in sports persons.

Materials and Methods: The present series include nine torn distal biceps tendons in eight patients, fixed anatomically to the radial tuberosity with an endobutton by using a single incision surgical technique; seven patients had suffered the injuries during contact sports. The passage of the endobutton was facilitated by using a blunt tipped pin in order to avoid injury to the posterior interosseous nerve. The patients were evaluated by Disabilities of the Arm, Shoulder and Hand (DASH) score and Mayo elbow score.

Results: The average age of the patients was 27.35 years (range 21–42 years). Average follow-up was 41.5 months (range 24–102 months). The final average flexion extension arc was 0°–143°, while the average pronation and supination angles were 77° (range 70°–82°) and 81° (range 78°–85°), respectively at the last followup. All the patients had a Disabilities of the Arm, Shoulder and Hand (DASH) score of 0 and a Mayo elbow score of 100 each. All the seven active sports persons were able to get back to their respective game. There was no nerve injury or any other complication.

Conclusions: The surgical procedure used by us is a simple, safe and reproducible technique giving minimal morbidity and better cosmetic results.

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References

  1. Sutton KM, Dodds SD, Ahmad CS, Sethi PM. Surgical treatment of distal biceps rupture. J Am Acad Orthop Surg 2010;18:139–48.

    Article  Google Scholar 

  2. Kokkalis ZT, Sotereanos DG. Biceps tendon injuries in athletes. Hand Clin 2009;25:347–57.

    Article  Google Scholar 

  3. D’Alessandro DF, Shields CL Jr, Tibone JE, Chandler RW. Repair of distal biceps tendon ruptures in athletes. Am J Sports Med 1993;21:114–9.

    Article  Google Scholar 

  4. Chillemi C, Marinelli M, De Cupis V. Rupture of the distal biceps brachii tendon: conservative treatment versus anatomic reinsertion-clinical and radiological evaluation after 2 years. Arch Orthop Trauma Surg 2007;127:705–8.

    Article  Google Scholar 

  5. Miyamoto RG, Elser F, Millett PJ. Distal biceps tendon injuries. J Bone Joint Surg Am 2010;92:2128–38.

    Article  Google Scholar 

  6. Baker BE, Bierwagen D. Rupture of the distal tendon of the biceps brachii. Operative versus non-operative treatment. J Bone Joint Surg Am 1985;67:414–7.

    Article  CAS  Google Scholar 

  7. Greenberg JA. Endobutton repair of distal biceps tendon ruptures. J Hand Surg Am 2009;34:1541–8.

    Article  Google Scholar 

  8. Rantanen J, Orava S. Rupture of the distal biceps tendon. A report of 19 patients treated with anatomic reinsertion, and a meta-analysis of 147 cases found in the literature. Am J Sports Med 1999;27:128–32.

    Article  CAS  Google Scholar 

  9. Meherin JM, Kilgore ES. The treatment of ruptures of the distal biceps brachii tendon. Am J Surg 1960;99:636–40.

    Article  Google Scholar 

  10. Boyd HB, Anderson LD. A method for reinsertion of the distal biceps brachii tendon. J Bone Joint Surg Am 1961;43:1041–3.

    Article  Google Scholar 

  11. Failla JM, Amadio PC, Morrey BF, Beckenbaugh RD. Proximal radioulnar synostosis after repair of distal biceps brachii rupture by the two-incision technique. Report of four cases. Clin Orthop Relat Res 1990;253:133–6.

    Google Scholar 

  12. Katzman BM, Caligiuri DA, Klein DM, Gorup JM. Delayed onset of posterior interosseous nerve palsy after distal biceps tendon repair. J Shoulder Elbow Surg 1997;6:393–5.

    Article  CAS  Google Scholar 

  13. Lin KH, Leslie BM. Surgical repair of distal biceps tendon rupture complicated by median nerve entrapment. A case report. J Bone Joint Surg Am 2001;83:741–3.

    Article  CAS  Google Scholar 

  14. Kelly EW, Morrey BF, O’Driscoll SW. Complications of repair of the distal biceps tendon with the modified two-incision technique. J Bone Joint Surg Am 2000;82:1575–81.

    Article  CAS  Google Scholar 

  15. Chavan PR, Duquin TR, Bisson LJ. Repair of the ruptured distal biceps tendon: a systematic review. Am J Sports Med 2008;36:1618–24.

    Article  Google Scholar 

  16. Berlet GC, Johnson JA, Milne AD, Patterson SD, King GJ. Distal biceps brachii tendon repair. An in vitro biomechanical study of tendon reattachment. Am J Sports Med 1998;26:428–32.

    Article  CAS  Google Scholar 

  17. Pereira DS, Kvitne RS, Liang M, Giacobetti FB, Ebramzadeh E. Surgical repair of distal biceps tendon ruptures: a biomechanical comparison of two techniques. Am J Sports Med 2002;30:432–6. 50.

    Article  Google Scholar 

  18. Lemos SE, Ebramzedeh E, Kvitne RS. A new technique: in vitro suture anchor fixation has superior yield strength to bone tunnel fixation for distal biceps tendon repair. Am J Sports Med 2004;32:406–10.

    Article  Google Scholar 

  19. Idler CS, Montgomery WH 3rd, Lindsey DP, Badua PA, Wynne GF, Yerby SA. Distal biceps tendon repair: a biomechanical comparison of intact tendon and 2 repair techniques. Am J Sports Med 2006;34:968–74.

    Article  Google Scholar 

  20. Kettler M, Lunger J, Kuhn V, Mutschler W, Tingart MJ. Failure strengths in distal biceps tendon repair. Am J Sports Med 2007;35:1544–8.

    Article  Google Scholar 

  21. Mazzocca AD, Burton KJ, Romeo AA, Santangelo S, Adams DA, Arciero RA. Biomechanical evaluation of 4 techniques of distal biceps brachii tendon repair. Am J Sports Med 2007;35:252–8.

    Article  Google Scholar 

  22. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 1996;29:602–8.

    Article  CAS  Google Scholar 

  23. Broberg MA, Morrey BF. Results of delayed excision of the radial head after fracture. J Bone Joint Surg Am 1986;68:669–74.

    Article  CAS  Google Scholar 

  24. Morrey BF, Askew LJ, An KN, Dobyns JH. Rupture of the distal tendon of the biceps brachii: A biomechanical study. J Bone Joint Surg Am 1985;67:418–21.

    Article  CAS  Google Scholar 

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

    Article  Google Scholar 

  26. O’Driscoll SW, Goncalves LB, Dietz P. The hook test for distal biceps tendon avulsion. Am J Sports Med 2007;35:1865–9.

    Article  Google Scholar 

  27. Giuffr`e BM, Moss MJ. Optimal positioning for MRI of the distal biceps brachii tendon: flexed abducted supinated view. AJR Am J Roentgenol 2004;182:944–6.

    Article  CAS  Google Scholar 

  28. Gupta RK, Singh D, Kansay R, Singh H. Cricket ball injury: a cause of symptomatic muscle hernia of leg. Br J Sports Med 2008;42:1002–3.

    Article  CAS  Google Scholar 

  29. El-Hawary R, Macdermid JC, Faber KJ, Patterson SD, King GJ. Distal biceps tendon repair: comparison of surgical techniques. J Hand Surg Am 2003;28:496–502.

    Article  Google Scholar 

  30. Peeters T, Ching-Soon NG, Jansen N, Sneyers C, Declercq G, Verstreken F. Functional outcome after repair of distal biceps tendon ruptures using the endobutton technique. J Shoulder Elbow Surg 2009;18:283–7.

    Article  Google Scholar 

  31. Karunakar MA, Cha P, Stern PJ. Distal biceps ruptures. A followup of Boyd and Anderson repair. Clin Orthop Relat Res 1999;363:100–7.

    Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics, Government Medical College Hospital, Chandigarh, Punjab, 160030, India

    Ravi K. Gupta, Nitin Bither, Harpreet Singh, Saurabh Kapoor, Ashish Chhabra & Sudhir Garg

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  1. Ravi K. Gupta
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  2. Nitin Bither
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  3. Harpreet Singh
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  4. Saurabh Kapoor
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  5. Ashish Chhabra
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Correspondence to Ravi K. Gupta.

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Gupta, R.K., Bither, N., Singh, H. et al. Repair of the torn distal biceps tendon by endobutton fixation. IJOO 46, 71–76 (2012). https://doi.org/10.4103/0019-5413.91638

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