Distal Biceps Tendon Ruptures: A Comparison of Surgical Techniques and Outcomes

Abstract

The rupture of a distal biceps tendon is a traumatic acute injury, that is also relatively rare. Because of this rarity, there remains a significant amount of controversy over which method of fixation is the preferred option. In addition to the controversy over which surgical method to use, it has been recently discovered that the distal biceps tendon actually consists of two tendons, which contribute individually to the movements of the forearm. The current most common methods of fixation include: interosseous tunnel, interference screw, cortical button, and cortical button with an interference screw. Although all of the options available serve as appropriate methods of fixation for the ruptured distal bicep tendon, the use of the cortical button with the interference screw has shown to be significantly stronger than the other options, while also allowing a more anatomical repair. Because of this, the cortical button with an interference screw fixation method may be able to become the standard protocol to repair the ruptured distal biceps tendon. After the surgery postoperative protocol consists of elbow immobilization for up to three weeks, followed by a rehabilitation with a focus on achieving full range of motion and normal strength and stabilization of the arm. Currently the surgical repair of ruptured distal biceps tendons is a standard practice with 97% of all patients returning to full pre-injury activity.14 With the continuing improvement in surgical procedures, one day there may be one standard surgical option available that has few complications, is minimally invasive, and has an extremely high success rate.