Mini-incision distal biceps tendon repair

Abstract

Rupture of the distal biceps tendon from its insertion on the bicipital tuberosity of the radius results in decreased forearm supination and flexion strength and range of motion. Due to this, primary repair of distal biceps ruptures are generally indicated in healthy and active individuals. Acute ruptures of the distal biceps tendon, defined as those diagnosed within 4 weeks of the index injury, tend to be amenable to “mini-incision” surgical repair. Both one- and two-mini-incision techniques have been well described in the literature, with each approach having its own unique drawbacks and benefits. Furthermore, there are multiple means by which to secure the distal biceps tendon to its insertion point on the radial tuberosity including suture fixation through transosseous tunnels, suture anchor fixation, interference screw fixation, and usage of cortical buttons. There has been significant debate in the literature regarding both the “best” approach and “strongest” method for fixation. This chapter will present an overview of acute ruptures of the distal biceps tendon and, in doing so, will describe in detail both the one-incision and two-incision techniques. This chapter will also review the current literature regarding outcomes for both the one- and two-incision techniques as well as the various methods for tendon reattachment and fixation.