[Surgical therapy of distal biceps tendon ruptures]

Ruptures of the distal biceps tendon are rare injuries which nearly exclusively occur in middle-aged men when eccentric load is applied to the flexed elbow. Operative treatment is supposed to be the most effective method to restore flexion and supination strength. However, there is a wide variety of potential surgical treatment methods. This article is aiming to present the anatomical, pathophysiological and epidemiological basics and to demonstrate the surgical techniques. Not only the approaches but also the differing fixation methods like bone tunnel fixation, endobutton- or suture anchor and interference screw are described in detail. Additionally, rehabilitation protocols and considerations concerning medical expertise are presented.