Kastanis G^1,2*, Kapsetakis P², Chaniotakis C², Stavrakakis I² and Pantouvaki A^1,3

Single Incision ¹Reconstructive Hand Surgery Unit, General Hospital of Heraklion, Venizeleio, Crete, Greece
²Department of Orthopaedic, General Hospital of Heraklion, Venizeleio, Crete, Greece
³Department of Physiotherapy, General Hospital of Heraklion, Venizeleio, Crete, Greece

*Corresponding Author: Kastanis G, Reconstructive Hand Surgery Unit, General Hospital of Heraklion, Venizeleio, Crete, Greece.

Received: June 16, 2022; Published: July 12, 2022

Introduction: Distal biceps brachii tendon detachment is an uncommon lesion which results from rapid elbow flexion against resistance and more often affects males between fourth and sixth decade of life. Among therapy options, surgical treatment leads to anatomic reinsertion of the tendon with better functional recovery. In literature, different methods have been proposed, regarding surgical treatment, with satisfactory outcomes. The aim of this study is to present the functional outcomes of our patients, in one year, who underwent surgical treatment with singe incision and cortical button implant and to analyze the complications and final patient satisfaction.

Material and Methods: From 2018 until 2020 thirty-five male patients underwent surgical repair for traumatic distal biceps tendon rupture with an average age of 40,5 years old (range from 22 to 68). Clinical diagnoses for the rupture were confirmed with ultrasound in majority of patients, and MRI in eight cases. The most common cause of lesion is rapid elbow flexion against resistance. All patients were repaired with anterior single incision, and cortical button fixation system while the average time from injury to surgery was 12,5 days (from 4 to 45 days). After operation, a functional elbow brace was applied, and all patients followed specific rehabilitation protocol.

Results: Mean time follow-up period was 18,9 months (range from 13 to 28 months). Results were evaluated according to complications, range of motion of elbow joint, Mayo Elbow Performance Score, Dash Score, EQ-5D-5L, and satisfaction of the patients. Major complications were paresthesia of posterior interosseous and lateral anterobrachial cutaneous nerves (17,1%). At the final reexamination the mean range of motion was flexion 135˚, extension -5˚, pronation 79˚ and supination 78˚, mean MEPS was 98,1 ± 8,4, mean Dash score was 8,5 ± 7,5, and the EQ-5D-5L was 93. The majority of patients was very satisfied (68,5%) and satisfied (25,8%) and only the 5,7% of cases was unsatisfied.

Conclusion: Distal biceps brachii reattachment with single incision and fixation with cortical button is a successful surgical method according to the superiority of biomechanical stabilization between other fixation system and better functional outcomes. Neurological complication, if presented, recovers in a relatively short period of time (range from 3 to 6 months) while patients return soon to the previous level of activity. Because all the surgical procedures of reattachment of distal biceps tendon rupture, present a large number of neurological, the patient should be informed of these conditions.

Keywords: Biceps Brachii Distal Tendon Rupture; Avulsion; Surgical Treatment; Single Incision Technique; Cortical Button Fixation System

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Citation

Citation: Kastanis G., et al. “Single Incision Approach and Cortical Button Fixation System for Distal Biceps Tendon Ruptures: Functional Outcomes and a Literature Review". Acta Scientific Orthopaedics 5.8 (2022): 33-42.

Copyright

Copyright: © 2022 Kastanis G., et al. 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.