Abstract
Rupture of the distal biceps brachii insertion is infrequent, representing only 3%
of biceps muscle injuries. The mechanism of injury in distal rupture involves a strong
contraction of the biceps tendon against unanticipated resistance. The injury is most
common in the dominant arm of middle-aged men. Symptoms include weakness in elbow
flexion (by 30%) and forearm supination (by 40%), often necessitating surgical repair
in the working individual. There are two described surgical procedures for the repair
of distal biceps ruptures with very good results. The modified Henry approach uses
a single anterior incision, whereas the Boyd-Anderson technique involves a small anterior
incision and a second posterolateral incision. Both of these techniques have been
modified over time. A distal biceps tendon rupture is defined as chronic if it is
greater than 4 weeks old. The results of surgical repair in chronic cases are less
sufficient and the surgical technique is more demanding. Partial rupture cases are
usually attritional and not associated with a traumatic event. Surgical treatment
in refractory cases involves detachment of the biceps tendon, debridement, and reattachment.
Distal biceps tendon ruptures repair is essential for laborers and athletic individuals
who need normal strength for their activities of daily living or sport. Copyright
© 2002 by the American Society for Surgery of the Hand
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References
References
- Rupture of biceps brachii: a conservative method of treatment.J Bone Joint Surg Am. 1967; 49: 1016
- Rupture of the distal insertion of the biceps brachii tendon.Clin Orthop. 1988; 234: 34-38
- Repair of biceps tendon ruptures in athletes.Am J Sports Med. 1993; 21: 114-119
- Avulsion of the lower biceps brachii tendon. Analysis of fifty-one previously unreported cases.Am J Surg. 1941; 51: 662-683
- Tendon injuries about the elbow.in: The Elbow and its Disorders. WB Saunders, Philadelphia1993: 492-504
- Unusual lesions of muscles and tendons of the shoulder girdle and upper arm.Clin Orthop. 1939; 68: 903-917
- Rupture of the distal tendon of the biceps brachii tendon.J Bone Joint Surg Am. 1985; 67: 414-417
- Complications of repair of the distal biceps tendon with the modified two-incision technique.J Bone Joint Surg Am. 2000; 82A: 1575-1581
- An etiological factor in tear of the distal tendon of the biceps brachii: report of two cases.J Bone Joint Surg Am. 1956; 38: 1365-1368
- Management of chronic biceps tendon rupture.Tech Hand Upper Extremity Surg. 2001; 5: 105-111
- The distal biceps tendon: two potential mechanisms involved in its rupture: arterial supply and mechanical impingement.J Shoulder Elbow Surg. 1995; 4: 149-156
- Avulsion of the insertion of the biceps brachii tendon and its surgical treatment.J Bone Joint Surg Am. 1963; 45: 1780-1781
- A method for reinsertion of the distal biceps brachii tendon.J Bone Joint Surg Am. 1961; 43: 1041-1043
- Proximal radioulnar synostosis after repair of distal biceps brachii rupture by the two-incision technique. Report of four cases.Clin Orthop. 1990; 253: 133-136
- Distal biceps brachii repair. Results in dominant and nondominant extremities.Clin Orthop. 1995; 317: 114-121
- Distal biceps ruptures: a followup of Boyd and Anderson Repair.Clin Orthop. 1999; 363: 100-107
- Ruptures of the distal tendon of the biceps brachii: a biomechanical study.J Bone Joint Surg Am. 1985; 67: 418-421
- Surgical treatment of distal biceps tendon ruptures: results of a multicenter BOTA study and review of the literature.Acta Orthop Belg. 1997; 63: 251-255
- Rupture of the distal biceps brachii tendon. Report of 13 cases.JAMA. 1963; 184: 60-63
- The treatment of ruptures of the distal biceps brachii tendon.Am J Surg. 1960; 99: 636-663
- Distal biceps tendon rupture.in: The Elbow. Raven Press, New York1994: 115-128
- Repair of avulsed insertion of biceps. A new technique in four cases.J Bone Joint Surg Br. 1993; 75: 938-939
- Distal rupture of the tendon of biceps brachii. Evaluation by MRI and the results of the repair.J Bone Joint Surg Br. 1996; 78: 767-770
- Repair of the distal biceps tendon using suture anchors and an anterior approach.Clin Orthop. 1996; 322: 116-119
- Repair of rupture of the distal tendon of biceps brachii. Review of the literature and report of three cases treated with a single anterior incision and suture anchors.Am J Orthop. 1997; 26: 151-156
- Surgical treatment of acute biceps tendon ruptures with a suture anchor.Acta Orthop Belg. 1993; 59: 426-429
- A simplified method for repair of distal biceps tendon ruptures.J Shoulder Elbow Surg. 2000; 9: 227-233
- Partial rupture of the distal biceps tendon.Clin Orthop. 1991; 271: 143-148
- Partial rupture of the distal biceps tendon.Clin Orthop. 2000; 374: 195-200
- Rupture of the distal biceps tendon: evaluation with MR imaging.Radiology. 1994; 190: 659-663
- Distal biceps tendon injury: MR imaging diagnosis.Radiology. 1994; 191: 203-206
- Median nerve compression in the proximal forearm as a complication of partial rupture of the distal biceps brachii tendon.J Hand Surg [Br]. 1992; 17: 5l5-517
- Partial rupture of the distal biceps brachii tendon. A case report.Acta Orthop Scand. 1987; 58: 287-288
- Partial rupture of the distal biceps tendon.J Shoulder Elbow Surg. 1996; 5: 73-75
- Partial rupture of the distal biceps tendon.J Shoulder Elbow Surg. 2001; 10: 377-379
- 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; 5: 342-346
- Distal biceps tendon injuries: diagnosis and management.J Am Acad Orthop Surg. 1999; 7: 199-207
- Repair of chronic distal biceps brachii tendon rupture using free autogenous semitendinosous tendon.Clin Orthop. 1996; 323: 188-191
- Operative treatment of post-traumatic proximal radioulnar synostosis.J Bone Joint Surg Am. 1998; 80: 248-257
- Later repair of simultaneous bilateral distal biceps brachii tendon avulsion with fascia lata graft.Br J Sports Med. 1999; 33: 281-283
- Avulsion of the distal biceps brachii tendon.Am J Surg. 1954; 88: 657-659
- Avulsion of rupture of distal tendon of biceps brachii muscle.Mo Med. 1973; 70: 821-822
- Rupture of the distal biceps brachii tendon.J Trauma. 1986; 26: 1061-1062
- Rupture of the distal biceps tendon.Acta Orthop Scand. 1977; 48: 280-282
- Repair of distal biceps tendon rupture.J Shoulder Elbow Surg. 2000; 9: 223-226
- Repair of distal biceps tendon rupture: a new technique using the endobutton.J Shoulder Elbow Surg. 2000; 9: 120-126
- A safe technique for distal biceps repair using a suture anchor and a limited anterior approach.Injury. 1999; 30: 233-237
- Distal biceps repair: a consistent and safe approach to the radial tuberosity.Orthopedics. 2000; 24: 113-116
- Long term evaluation of repaired distal biceps brachii tendon ruptures.Clin Orthop. 1996; 333: 186-191
- Tendon injuries about the elbow.in: The Elbow and Its Disorders. WB Saunders, Philadelphia1993: 492-504
- Post-traumatic proximal radio-ulnar synostosis.J Bone Joint Surg Am. 1989; 71: 1208-1213
- Distal biceps brachii tendon avulsion: a simplified method of operative repair.Am J Sports Med. 1986; 14: 234-236
- Repair of the avulsion of insertion of biceps brachii tendon.Clin Orthop. 1985; 193: 189-194
- Distal biceps brachii tendon repair. An in vitro biomechanical study of tendon reattachment.Am J Sports Med. 1998; 26: 428-432
- A comparison of methods of tendon fixation in a model of distal biceps tendon avulsion.J Bone Joint Surg Br. 2001; 83: 450
Article info
Publication history
1531-0914/02/0203-0002$35.00/0
Identification
Copyright
© 2002 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
