Distal biceps tendon ruptures: a historical perspective and current concepts

Distal biceps tendon rupture is a relatively rare injury most commonly seen in the dominant extremity of men between 40 and 60 years of age. It occurs when an eccentric extension force is applied to a contracting biceps muscle. The hallmark finding is a palpable defect in the distal biceps, which is accentuated by elbow flexion. Radiographic evaluation is usually not necessary. Acute surgical repair is advocated for optimal return of function by either a one-incision or a modified two-incision muscle-splitting technique. The arm is protected for 6 to 8 eight weeks after surgery. Unrestricted range of motion and gentle strengthening may begin after the 6 - 8 week protection period. Return to unrestricted activity is usually allowed by 5 months after surgery.