Minimally Invasive Anterior Two-Incision Approach for Repair of a Chronic Neglected Distal Biceps Tendon Rupture

Overview

Journal J Orthop Case Rep

Specialty Orthopedics

Date 2019 Feb 12

PMID 30740379

Authors

Ashay A Kale

Laith M Jazrawi

Neel K Kale

Affiliations

Soon will be listed here.

Abstract

Introduction: Rupture of the distal biceps brachii results in significant weakness and limitation of function in those affected. Acute ruptures of the biceps tendon are generally best treated with early repair, ideally within 3weeks of injury. The preferred treatment of chronic ruptures is still uncertain.

Case Report: We present a case of a chronic distal biceps tendon rupture repaired with a novel, two-incision, minimally invasive anterior approach utilizing an Achilles tendon allograft and cortical button fixation, in a patient with a high demand occupation as a cabinet maker.

Conclusion: Numerous surgical techniques have been described for the repair or reconstruction of chronic distal biceps ruptures. Most described techniques have utilized an extensile anterior approach or an extensile anterior approach combined with another posterolateral incision. We believe that this minimally invasive approach allows for better cosmesis and quicker recovery and return to work in patients with high demand occupations.

References

Ramsey M . Distal biceps tendon injuries: diagnosis and management. J Am Acad Orthop Surg. 1999; 7(3):199-207. DOI: 10.5435/00124635-199905000-00006. View

Levy H, Mashoof A, Morgan D . Repair of chronic ruptures of the distal biceps tendon using flexor carpi radialis tendon graft. Am J Sports Med. 2000; 28(4):538-40. DOI: 10.1177/03635465000280041501. View

Kelly E, Morrey B, ODriscoll S . Complications of repair of the distal biceps tendon with the modified two-incision technique. J Bone Joint Surg Am. 2000; 82(11):1575-81. DOI: 10.2106/00004623-200011000-00010. View

Sanchez-Sotelo J, Morrey B, Adams R, ODriscoll S . Reconstruction of chronic ruptures of the distal biceps tendon with use of an achilles tendon allograft. J Bone Joint Surg Am. 2002; 84(6):999-1005. DOI: 10.2106/00004623-200206000-00015. View

Klonz A, Loitz D, Wohler P, Reilmann H . Rupture of the distal biceps brachii tendon: isokinetic power analysis and complications after anatomic reinsertion compared with fixation to the brachialis muscle. J Shoulder Elbow Surg. 2003; 12(6):607-11. DOI: 10.1016/s1058-2746(03)00212-x. View

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(8):705-8. DOI: 10.1007/s00402-007-0326-7. View

Hamer M, Caputo A . Operative treatment of chronic distal biceps tendon ruptures. Sports Med Arthrosc Rev. 2008; 16(3):143-7. DOI: 10.1097/JSA.0b013e3181824e76. View

Pearce McCarty 3rd L, Alpert J, Bush-Joseph C . Reconstruction of a chronic distal biceps tendon rupture 4 years after initial injury. Am J Orthop (Belle Mead NJ). 2008; 37(11):579-82. View

Freeman C, McCormick K, Mahoney D, Baratz M, Lubahn J . Nonoperative treatment of distal biceps tendon ruptures compared with a historical control group. J Bone Joint Surg Am. 2009; 91(10):2329-34. DOI: 10.2106/JBJS.H.01150. View

10.

Failla J, Amadio P, Morrey B, Beckenbaugh R . 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. View

11.

Snir N, Hamula M, Wolfson T, Meislin R, Strauss E, Jazrawi L . Clinical outcomes after chronic distal biceps reconstruction with allografts. Am J Sports Med. 2013; 41(10):2288-95. DOI: 10.1177/0363546513502306. View

12.

Schmidt C, Brown B, Sawardeker P, DeGravelle Jr M, Miller M . Factors affecting supination strength after a distal biceps rupture. J Shoulder Elbow Surg. 2013; 23(1):68-75. DOI: 10.1016/j.jse.2013.08.019. View

13.

BAKER B, Bierwagen D . Rupture of the distal tendon of the biceps brachii. Operative versus non-operative treatment. J Bone Joint Surg Am. 1985; 67(3):414-7. View

14.

Morrey B, Askew L, An K, Dobyns J . Rupture of the distal tendon of the biceps brachii. A biomechanical study. J Bone Joint Surg Am. 1985; 67(3):418-21. View

15.

Hang D, Bach Jr B, Bojchuk J . Repair of chronic distal biceps brachii tendon rupture using free autogenous semitendinosus tendon. Clin Orthop Relat Res. 1996; (323):188-91. DOI: 10.1097/00003086-199602000-00025. View

16.

Hudak P, Amadio P, 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(6):602-8. DOI: 10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L. View