Distal biceps rupture: evaluation of results with double fixation technique
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Published:
Nov 1, 2013
Keywords:
Biceps tendon, Distal rupture, Double fixation technique
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Abstract
BackgroundThe distal biceps rupture is an unusual lesion produced when an eccentric force is applied to the bent elbow. The aim of this work is to analyze the results for the reinsertion of the distal biceps with a double fixation technique of cortical button and biotenodesis interference screw through a single anterior incision.MethodsBetween August 2008 and February 2013 we registered 19 cases of distal biceps rupture, surgically treated through an anterior limited procedure. The last 17 consecutive cases were treated with double fixation using an extracortical button and biotenodesis screw and are part of this study. All the patients were males with a median age of 41 years (range 27-59). The patients were evaluated using the DASH questionnaire and the subjective/objective scoring system of Andrews and Carson, controlling the flexion and supination forces with the British Medical Research Council scale, modified by Mackinnon and Dellon (M0-M5).ResultsDASH questionnaire obtained a median value of 1.7 (0-5.83), and the Andrews and Carson score had a median value of 195 (170-200) for the total; with 15 excellent results and 2 good results. All patients achieved a force of M5 in flexion and supination of the forearm. The follow-up had a median of 12 months (4-32). Complications were registered in two patients, both recovered ad integrum.ConclusionThe described technique proved to be both reliable and effective, giving satisfactory results with a low complication rate.
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Capomassi, M. Ángel, Gardenal, R. M., Slullitel, M., Suárez, E., & Benedetto, I. (2013). Distal biceps rupture: evaluation of results with double fixation technique. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 78(4), 171-179. https://doi.org/10.15417/241
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Clinical Research
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References
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3. El-Hawary R, MacDermid J, Faber K, Patterson S, King G. Distal biceps tendon repair: comparison of surgical techniques. J Hand Surg Am 2003;28:496-502.
4. Mazzocca AD, Bicos J, Arciero RA, Romeo AA, Cohen MS, Nicholson G. Repair of distal biceps tendon ruptures using a combined anatomic interference screw and cortical button. Tech Shoulder Elbow Surg 2005;6(2):108-15.
5. 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(2):252-8.
6. SethiP, Cunningham J, Miller S, Sutton K, Mazzocca A. Anatomical repair of the distal biceps tendon using the Tension-Slide Technique. Tech Shoulder Elbow Surg 2008;9(4):182-7.
7. Kelly E, Morrey BF, O’Driscoll S. Complications of repair of the distal biceps tendon with the modified two-incision technique. J Bone Joint Surg Am 2000;82:1575-81.
8. John CK, Field LD, Weiss KS, Savoie FH 3rd. Single-incision repair of acute distal biceps ruptures by use of suture anchors. J Shoulder Elbow Surg 2007;16(1):78-83.
9. Kobayashi K, Bruno RJ, Cassidy C. Single anterior incision suture anchor technique for distal biceps tendon ruptures. Orthopedics
2003;26(8):767-70.
10. Bain GI, Prem H, Hepinstall RJ, Verhellen R, Paix D. Repair of distal biceps tendon rupture: a new technique using the Endobutton.
J Shoulder Elbow Surg 2000;9:120-6.
11. Silva J, Eskander MS, Lareau C, DeAngelis NA. Treatment of distal biceps tendon ruptures using a single-incision technique and a bio-tenodesis screw. Orthopedics 2010;33(7):477.
12. McKee MD, Hirji R, Schemitsch EH, Wild LM, Waddell JP. Patient-oriented functional outcome after repair of distal biceps tendon ruptures using a single-incision technique. J Shoulder Elbow Surg 2005;14(3):302-6.
13. Fischer WR, Shepance LA. Avulsion of the insertion of the biceps brachii. Report of a case. J Bone Joint Surg Am 1956;38:158-9.
14. Boyd HB, Anderson LD. A method for reinsertion of the distal biceps brachii tendon. J Bone Joint Surg Am 1961;43:1041-3.
15. 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.
16. Andrews JR, Carson WG. Arthroscopy of the elbow. Arthroscopy 1985;1:97-107.
17. Medical Research Council. Nerve Injuries Committee. Results of nerve suture. En: Seddon H, ed. Peripheral Nerve Injurie . London: Her Majesty’s Stationery Office; 1954.
18. Mackinnon SE, Dellon AL. Results of nerve repair and grafting: Surgery of the Peripheral Nerve. New York: Thieme; 1988, p. 115
19. Sutton KM, Dodds SD, Ahmad CS, Sethi PM. Surgical treatment of distal biceps rupture. J Am Acad Orthop Surg 2010; 18(3):139-48.
20. Morrey BF, Askew LJ, An KN, Dobyns JH. Rupture of the distal biceps tendon: biomechanical assessment of different treatment options. J Bone Joint Surg Am 1985;67:418-26.
21. Idler CS, Montgomery WH III, 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.
22. Cohen MS. Complications of distal biceps tendon repairs. Sports Med Arthrosc Rev 2008;16:148-53.
23. Potapov A, Laflamme YG, Gagnon S, Canet F, Rouleau DM. Progressive osteolysis of the radius after distal biceps tendon repair with the bioabsorbable screw. J Shoulder Elbow Surg 2011;20:819-26.
24. Heinzelmann AD, Savoie FH 3rd, Ramsey JR, Field LD, Mazzocca AD. A combined technique for distal biceps repair using a soft tissue button and biotenodesis interference screw. Am J Sports Med 2009;37:989-94
2. Hetsroni I, Pilz-Burstein R, Nyska M, Back Z, Barchilon V, Mann G. Avulsion of the distal biceps brachii tendon in middleaged population: is surgical repair advisable? A comparative study of 22 patients treated with either nonoperative management or early anatomical repair. Injury 2008;39(7):753-60.
3. El-Hawary R, MacDermid J, Faber K, Patterson S, King G. Distal biceps tendon repair: comparison of surgical techniques. J Hand Surg Am 2003;28:496-502.
4. Mazzocca AD, Bicos J, Arciero RA, Romeo AA, Cohen MS, Nicholson G. Repair of distal biceps tendon ruptures using a combined anatomic interference screw and cortical button. Tech Shoulder Elbow Surg 2005;6(2):108-15.
5. 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(2):252-8.
6. SethiP, Cunningham J, Miller S, Sutton K, Mazzocca A. Anatomical repair of the distal biceps tendon using the Tension-Slide Technique. Tech Shoulder Elbow Surg 2008;9(4):182-7.
7. Kelly E, Morrey BF, O’Driscoll S. Complications of repair of the distal biceps tendon with the modified two-incision technique. J Bone Joint Surg Am 2000;82:1575-81.
8. John CK, Field LD, Weiss KS, Savoie FH 3rd. Single-incision repair of acute distal biceps ruptures by use of suture anchors. J Shoulder Elbow Surg 2007;16(1):78-83.
9. Kobayashi K, Bruno RJ, Cassidy C. Single anterior incision suture anchor technique for distal biceps tendon ruptures. Orthopedics
2003;26(8):767-70.
10. Bain GI, Prem H, Hepinstall RJ, Verhellen R, Paix D. Repair of distal biceps tendon rupture: a new technique using the Endobutton.
J Shoulder Elbow Surg 2000;9:120-6.
11. Silva J, Eskander MS, Lareau C, DeAngelis NA. Treatment of distal biceps tendon ruptures using a single-incision technique and a bio-tenodesis screw. Orthopedics 2010;33(7):477.
12. McKee MD, Hirji R, Schemitsch EH, Wild LM, Waddell JP. Patient-oriented functional outcome after repair of distal biceps tendon ruptures using a single-incision technique. J Shoulder Elbow Surg 2005;14(3):302-6.
13. Fischer WR, Shepance LA. Avulsion of the insertion of the biceps brachii. Report of a case. J Bone Joint Surg Am 1956;38:158-9.
14. Boyd HB, Anderson LD. A method for reinsertion of the distal biceps brachii tendon. J Bone Joint Surg Am 1961;43:1041-3.
15. 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.
16. Andrews JR, Carson WG. Arthroscopy of the elbow. Arthroscopy 1985;1:97-107.
17. Medical Research Council. Nerve Injuries Committee. Results of nerve suture. En: Seddon H, ed. Peripheral Nerve Injurie . London: Her Majesty’s Stationery Office; 1954.
18. Mackinnon SE, Dellon AL. Results of nerve repair and grafting: Surgery of the Peripheral Nerve. New York: Thieme; 1988, p. 115
19. Sutton KM, Dodds SD, Ahmad CS, Sethi PM. Surgical treatment of distal biceps rupture. J Am Acad Orthop Surg 2010; 18(3):139-48.
20. Morrey BF, Askew LJ, An KN, Dobyns JH. Rupture of the distal biceps tendon: biomechanical assessment of different treatment options. J Bone Joint Surg Am 1985;67:418-26.
21. Idler CS, Montgomery WH III, 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.
22. Cohen MS. Complications of distal biceps tendon repairs. Sports Med Arthrosc Rev 2008;16:148-53.
23. Potapov A, Laflamme YG, Gagnon S, Canet F, Rouleau DM. Progressive osteolysis of the radius after distal biceps tendon repair with the bioabsorbable screw. J Shoulder Elbow Surg 2011;20:819-26.
24. Heinzelmann AD, Savoie FH 3rd, Ramsey JR, Field LD, Mazzocca AD. A combined technique for distal biceps repair using a soft tissue button and biotenodesis interference screw. Am J Sports Med 2009;37:989-94