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Factors affecting supination strength after a distal biceps rupture
Christopher C Schmidt1, Brandon T Brown2, Prasad J Sawardeker3
1Orthopaedic Specialists- UPMC, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Distal biceps avulsion significantly reduces supination strength, particularly in neutral forearm positions. While pain and disability scores improve over time, strength recovery varies, suggesting brachioradialis strengthening may aid some functional return.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Rehabilitation Science
Background:
- Distal biceps tendon avulsion is a debilitating injury affecting forearm supination strength.
- Nonoperative management is a consideration for some patients, but functional recovery potential is not fully understood.
Purpose of the Study:
- To quantify pain, disability, and isometric supination torque in patients with biceps deficiency.
- To assess functional recovery potential with nonoperative treatment for distal biceps avulsion.
Main Methods:
- Prospective cohort study of 23 men with unilateral distal biceps avulsion.
- Isometric supination strength testing at 3 forearm positions (pronation, neutral, supination).
- Assessment of pain (visual analog pain scale [VAPS]) and disability (Disabilities of the Arm, Shoulder and Hand [DASH]).
Main Results:
- Biceps rupture caused a 60% decrease in supination strength in the neutral forearm position.
- Peak torque was greater in pronation compared to supination, irrespective of injury.
- Pain and disability scores improved over time but did not correlate with strength recovery.
Conclusions:
- Significant supination strength deficits persist after distal biceps avulsion.
- Forearm position influences peak torque, with pronation offering a mechanical advantage.
- Brachioradialis strengthening may improve strength from pronation to neutral, but neutral to supination deficits are challenging to overcome.
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