Anatomic Restoration of the Biceps Brachii Insertion Through a Single Anterior Incision

Treatment of distal biceps tendon ruptures with surgical repair has been shown to restore peak elbow flexion and supination strength, as well as minimize fatigue with repetitive activity. The anatomic footprint of the biceps is slightly posterior to the apical prominence of the bicipital tuberosity. Single-incision and double-incision methods for repairing distal biceps tendon ruptures have been described. However, previously described single-incision techniques have been unable to accurately re-establish the anatomic position of the tendinous insertion. We describe our technique of performing an anatomic distal biceps repair using a single anterior incision. The proposed benefits of this technique include the restoration of the anatomic footprint area, insertion site, and consequently the native cam effect of the bicipital tuberosity all through a single incision. From a patient's perspective, the proposed benefit of this technique includes the restoration of supination strength using a single incision.