Abstract

Introduction: Acute disruption of the distal biceps tendon is a rare injury that occurs due to eccentric contraction force on the elbow. Several techniques for reattachment of the avulsed tendon were described in the literature but no one had proved utmost efficiency over the other techniques. The purpose of this study is to evaluate the results of a simple technique for reattaching the tendon.

Methods: This is a retrospective evaluation of the use of a combined simple two fixation methods through a single anterior approach in 9 patients aiming to avoid the possible difficulties and complications reported with the other techniques.

Results: Were evaluated with the Mayo elbow score and showed 6 excellent cases (66.6%), 2 good (22.2%) and one fair (11.1%). Good and comparable results to the other fixation techniques were also obtained with minimal complications.

Conclusion: The described simple combined fixation of avulsed distal biceps tendon by two anchors and trans-osseous tunnel through one anterior approach is an easy reproducible technique with minimal complications.

Keywords: Avulsion; Distal Biceps; Suture Anchors; Trans-osseous Suture

References

1. MR Safran and SM Graham. “Distal biceps tendon ruptures: incidence, demographics, and the effect of smoking”. Clinical Orthopaedics and Related Research 404 (2002): 275-283.
2. C Savvidou and R Moreno. “Spontaneous distal biceps tendon ruptures: are they related to statin administration?” Hand Surgery2 (2012): 167-171.
3. Cucca YY., et al. “The biceps brachii muscle and its distal insertion: observations of surgical and evolutionary relevance”. Surgical and Radiologic Anatomy4 (2010): 371-375.
4. van den Bekerom J., et al. “Clinical relevance of distal biceps insertional and footprint anatomy”. Knee Surgery, Sports Traumatology, Arthroscopy 7 (2016): 2300-2307.
5. Hackl M., et al. “The course of the posterior interosseous nerve in relation to the proximal radius: is there a reliable landmark?” Injury 4 (2015): 687-692.
6. DD Savin., et al. “Surgical Management of Acute Distal Biceps Tendon Ruptures, Current concepts review”. Journal of Bone and Joint Surgery 99 (2017): 785-796 d.
7. M Citak., et al. “Surgical repair of the distal biceps brachii tendon: a comparative study of three surgical fixation techniques”. Knee Surgery, Sports Traumatology, Arthroscopy11 (2011): 1936-1941.
8. JA Recordon., et al. “Endobutton versus transosseous suture repair of distal biceps rupture using the two-incision technique: a comparison series”. Journal of Shoulder and Elbow Surgery6 (2015): 928- 933.
9. L Balabaud., et al. “Repair of distal biceps tendon ruptures using a suture anchor and an anterior approach”. The Journal of Hand Surgery British2 (2004): 178-182.
10. T Gregory., et al. “Repair of distal biceps tendon rupture using a suture anchor: description of a new endoscopic procedure”. The American Journal of Sports Medicine3 (2009): 506-511.
11. GI Bain., et al. “Repair of distal biceps tendon rupture: a new technique using the Endobutton”. Journal of Shoulder and Elbow Surgery2 (2000): 120-126.
12. JA Greenberg., et al. “EndoButton-assisted repair of distal biceps tendon ruptures”. Journal of Shoulder and Elbow Surgery 5 (2003): 484- 490.
13. J King and M Bollier. “Repair of distal biceps tendon ruptures using the EndoButton”. Journal of the American Academy of Orthopaedic Surgeons8 (2008): 490-494.
14. S Siebenlist., et al. “The double intramedullary cortical button fixation for distal biceps tendon repair”. Knee Surgery, Sports Traumatology, Arthroscopy11 (2011): 1925-1929.
15. W Khan., et al. “Repair of distal biceps tendon rupture with the Biotenodesis screw”. Archives of Orthopaedic and Trauma Surgery3 (2004): 206-208.
16. AD Heinzelmann., et al. “A combined technique for distal biceps repair using a soft tissue button and biotenodesis interference screw”. The American Journal of Sports Medicine5 (2009): 989-994.
17. S Sharma and G MacKay. “Endoscopic repair of distal biceps tendon using an EndoButton”. Arthroscopy7 (2005): 897.e1-897.e4.
18. Cusick MC., et al. “Accuracy and reliability of the Mayo Elbow Performance Score”. Journal of Hand Surgery 6 (2014): 1146-1150.
19. JN Watson., et al. “Repair techniques for acute distal biceps tendon ruptures: a systematic review”. The Journal of Bone and Joint Surgery-American Volume24 (2014): 2086-2090.
20. IF Kodde., et al. “Re-fixation techniques and approaches for distal biceps tendon ruptures: a systematic review of clinical studies”. Journal of Shoulder and Elbow Surgery 2 (2016): e29-e37.
21. R El-Hawary., et al. “Distal biceps tendon repair: comparison of surgical techniques”. The Journal of Hand Surgery 3 (2003): 496-502.
22. PR Chavan., et al. “Repair of the ruptured distal biceps tendon: a systematic review”. American Journal of Sports Medicine8 (2008): 1618-1624.
23. TS Johnson., et al. “One-versus two-incision technique for distal biceps tendon repair”. HSS Journal 2 (2008): 117-122.
24. PM Sethi and JE Tibone. “Distal biceps repair using cortical button fixation”. Sports Medicine and Arthroscopy Review 3 (2008): 130-135.
25. DM Rose., et al. “Biomechanical analysis suggests early rehabilitation is possible after single-incision EndoButton distal biceps repair with FiberWire”. Knee Surgery, Sports Traumatology, Arthroscopy6 (2011): 1019-1022.
26. M Banerjee., et al. “High complication rate following distal biceps refixation with cortical button”. Archives of Orthopaedic and Trauma Surgery10 (2013): 1361-1366.
27. HA Bosman., et al. “Anatomic direct repair of chronic distal biceps brachii tendon rupture without interposition graft”. Journal of Shoulder and Elbow Surgery10 (2012): 1342-1347.
28. RA Cain., et al. “Complications following distal biceps repair”. The Journal of Hand Surgery10 (2012): 2112-2117.
29. MT Dillon., et al. “Repair of acute and chronic distal biceps tendon ruptures using the EndoButton”. Hand1 (2011): 39-46.
30. R K Gupta., et al. “Repair of the torn distal biceps tendon by endobutton fixation”. Indian Journal of Orthopaedics1 (2012): 71-76.
31. IF Kodde., et al. “Reconstruction of distal biceps tendon ruptures with a cortical button”. Knee Surgery, Sports Traumatology, Arthroscopy3 (2015): 919-925.
32. V Agrawal and M J Stinson. “Case report: Heterotopic ossification after repair of distal biceps tendon rupture utilizing a single-incision Endobutton technique”. Journal of Shoulder and Elbow Surgery1 (2005): 107-109.
33. SS Desai., et al. “Failed distal biceps tendon repair using a single-incision EndoButton technique and its successful treatment: case report”. Journal of Hand Surgery American12 (2010): 1986-1989.
34. MT Dillon and DJ Lepore. “Heterotopic ossification after single-incision distal biceps tendon repair with an endobutton”. Journal of Surgical Orthopaedic Advances3 (2011): 198-201.
35. MR Fajardo., et al. “Multiple nerve injuries following repair of a distal biceps tendon rupture: case report and review of the literature”. Bulletin of the Hospital for Joint Diseases2 (2013): 166-169.
36. PT Nigro., et al. “Prognosis for recovery of posterior interosseous nerve palsy after distal biceps repair”. Journal of Shoulder and Elbow Surgery1 (2013): 70-73.
37. EY Lo., et al. “The effect of drill trajectory on proximity to the posterior interosseous nerve during cortical button distal biceps repair”. Arthroscopy8 (2011): 1048-1054.
38. N Thumm., et al. “Proximity of the posterior interosseous nerve during cortical button guidewire placement for distal biceps tendon reattachment”. The Journal of Hand Surgery-American 3 (2015): 534-536.
39. J van den Bogaerde and E Shin. “Posterior interosseous nerve incarceration with endobutton repair of distal biceps”. Orthopedics 1 (2015): e68-e71.
40. JRA Smith and R Amirfeyz. “Does immediate elbow mobilization after distal biceps tendon repair carry the risk of wound breakdown, failure of repair, or patient dissatisfaction”. Journal of Shoulder and Elbow Surgery 5 (2016): 810- 815.
41. AF Vidal., et al. “Extensive heterotopic ossification after suspensory cortical fixation of acute distal biceps tendon ruptures”. Arthroscopy7 (2012): 1036-1040.
42. T Peeters., et al. “Functional outcome after repair of distal biceps tendon ruptures using the endobutton technique”. Journal of Shoulder and Elbow Surgery2 (2009): 283- 287.
43. EE Spencer Jr., et al. “Is therapy necessary after distal biceps tendon repair?” Hand 4 (2008): 316-319.
44. A Panagopoulos., et al. “Clinical Outcomes and Complications of Cortical Button Distal Biceps Repair: A Systematic Review of the Literature”. Journal of Sports Medicine (2016).
45. CL Camp., et al. “Single incision technique for repair of distal biceps tendon avulsions with intramedullary cortical button”. Arthroscopy Techniques2 (2016): e303-e307.
46. T Huynh., et al. “Outcomes and Complications After repair of Complete Distal Biceps Tendon Rupture with the Cortical Button Technique”. JBJS Open Access (2019): e0013.

Citation

Citation: Ahmed Refaat Khamis. “Simple Technique for Repair of Avulsed Distal Biceps Tendon through One Approach. Case Series and Literature Review".Acta Scientific Orthopaedics 3.11 (2020): 24-32.

Copyright

Copyright: © 2020 Ahmed Refaat Khamis. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.