Immediate range of motion after distal biceps tendon repair

The purpose of this study was to determine the effect of immediate postoperative motion on strength and elbow motion after repair of a distal biceps tendon rupture. We conducted a retrospective review of 13 patients who had repairs of a unilateral distal biceps tendon rupture with a minimum follow-up of 2 years. The repairs were performed via a 2-incision technique. The elbows were placed into hinged braces immediately postoperatively, and range of motion was limited to 60 degrees of flexion to full limitation on flexion on the first postoperative day. Elbow extension block was decreased to 40 degrees at 2 weeks, 20 degrees at 4 weeks, and full extension at 6 weeks postoperatively. Elbow range of motion, biceps strength, and Disabilities of the Arm, Shoulder, and Hand scores were recorded at follow-up. There was a mean loss of 5.8 degrees of full extension when compared with the uninjured side, with no loss of flexion. There was a mean loss of 3.5 degrees of pronation and 8.1 degrees of supination. Flexion strength was 91.4% and supination strength was 89.4% of that of the uninjured side. The mean Disabilities of the Arm, Shoulder, and Hand score was 42.8. We conclude that immediate postoperative range of motion after repair of the distal biceps tendon leads to early gain of extension and has no deleterious effect on healing or strength.