A simplified method for repair of distal biceps tendon ruptures

Repair of distal biceps brachii tendon ruptures is recommended for active individuals desiring maximum return of elbow supination and flexion strength. A 2-incision method of repair has been most popular but carries a risk of radioulnar synostosis. In the past, repair through a single anterior incision required more dissection and risked injury to the posterior interosseous nerve. The authors present a simplified method for the repair of distal biceps tendon ruptures through a single anterior incision. The use of suture anchors provides secure fixation to the radius with minimal volar dissection. This method was used successfully in 16 patients, 8 acutely (<6 weeks) and 8 chronically, with excellent functional results. Patients who received acute repairs regained elbow strength and power; patients who received chronic repairs showed slight deficits of supination strength (16%) and flexion power (14%). Of 10 chronic ruptures treated, only 2 tendons could not be mobilized back to the radial tuberosity and had to be transferred to the brachialis. There were no failures and no complications of radioulnar synostosis or posterior interosseous nerve palsy. The single anterior incision approach in which suture anchors are used is recommended as an alternative to the traditional 2-incision method.