[Distal biceps tendon rupture. Therapy and forensic insurance evaluation]

Compared with proximal ruptures of the biceps sinew, distal ruptures of the biceps sinew are extremely rare and generally need operative treatment. However, the large number of different operation techniques described in literature clearly shows that a safe method of treatment has still not been found. In the "Bergmannsheil" Hospital in Gelsenkirchen-Buer, 11 distal ruptures of the biceps sinew in 10 patients were operatively treated during 1985 and 1989. The average age of the patients was 44.6 years. All accidents occurred during physical work. The account of how the accident had happened suggested that accident and injury were related in 8 cases, especially when the findings at operation and the course were also taken into consideration. In 3 cases the rupture of the biceps sinew was not caused by any outward influence. The operative treatment took the form of transosseous reinsertion of the biceps sinew in a modification of Platt's technique in 6 patients; in 1 case the sinew was restored by means of a fascia late strip even though 49 days had passed since the accident. In the course of follow-up examinations we noted a considerable deficit of supination power remaining in the affected lower arm, although the clinical results were good otherwise; we have therefore developed our own method, taking particular account of the essentially more important function of the biceps brachii muscle as a supinator in addition to its flexion function. The method applied is described. At the follow-up examination distinctly better supination power was noted in the 4 patients operated on by this method; the flexibility of the cubital joint was not reduced.(ABSTRACT TRUNCATED AT 250 WORDS)