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Optimization of Anterior Incision Placement for Distal Biceps Repair.

Nikolai Klebanov1, David H Wei2, Brendan J Harrison3

  • 1Dermatology, Massachusetts General Hospital, Boston, USA.

Cureus
|October 23, 2018
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Summary

A new mathematical model predicts biceps tuberosity location using patient height, BMI, and sex. This aids surgeons in distal biceps tendon repair, preventing posterior interosseous nerve (PIN) damage.

Keywords:
biceps tendonbiceps tendon ruptureradiographic anatomy

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Area of Science:

  • Orthopedic Surgery
  • Anatomy
  • Biomechanical Engineering

Background:

  • Posterior interosseous nerve (PIN) injury is a risk during distal biceps tendon repair with cortical buttons.
  • Drill trajectory impacts PIN proximity during surgery.

Purpose of the Study:

  • Develop a mathematical model to predict biceps tuberosity location.
  • Utilize patient demographics and a palpable landmark to guide surgical approaches.

Main Methods:

  • Retrospective review of 82 patient records and elbow radiographs.
  • Measurement of olecranon-tuberosity distance (OTD) using radiographic software.
  • Multivariate regression analysis and cadaveric validation.

Main Results:

  • OTD varies significantly with height, BMI, and sex.
  • Height, BMI, and male sex are significant predictors of OTD.
  • Cadaveric validation showed an average error of 1.8 mm.

Conclusions:

  • A predictive mathematical model for biceps tuberosity location is accurate.
  • Model uses patient height, BMI, and sex, guiding incision placement for distal biceps tendon repair.
  • Further research will focus on model accuracy at measurement extremes.