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Related Experiment Video

Updated: Dec 22, 2025

Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
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Chronic distal biceps avulsion treated with suture button.

Craig A Zeman1, Joseph D Mueller2, Brent R Sanderson2

  • 1Ventura Orthopedics, Clinical Faculty at Community Memorial Health System Orthopedic Residency, Ventura, CA, USA.

Journal of Shoulder and Elbow Surgery
|May 9, 2020
PubMed
Summary

Suture button repair of chronic distal biceps tendon avulsions effectively restores strength and range of motion without grafts. This technique offers excellent outcomes for patients with these challenging injuries.

Keywords:
ChronicEndoButtonavulsionbicepbuttondistalflexionrupture

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Tendon Repair

Background:

  • Distal biceps tendon avulsions represent a small percentage of all biceps ruptures.
  • Nonoperative treatment leads to significant loss of elbow function, including strength and endurance.
  • Traditional operative management for chronic injuries often involves graft augmentation.

Purpose of the Study:

  • To evaluate the efficacy of a suture button technique for repairing chronic distal biceps tendon avulsions.
  • To assess functional outcomes and patient satisfaction without the use of allograft augmentation.
  • To determine if a single transverse incision approach is effective for these injuries.

Main Methods:

  • Retrospective review of 20 patients (21 injuries) with chronic distal biceps tendon avulsions.
  • Surgical repair using a suture button through a single transverse incision.
  • Postoperative assessment of range of motion, flexion/supination strength, and validated outcome scores (ASES, VAS, MEPS, OES).

Main Results:

  • All patients achieved full range of motion and 5/5 flexion/supination strength.
  • Significant improvements in MEPS, ASES, OES, and VAS scores were observed postoperatively.
  • Two patients experienced transient radial nerve neuropathy; one had persistent palsy. Four reported supination fatigue.

Conclusions:

  • Chronic distal biceps tendon ruptures can be successfully repaired using a single-incision suture button technique without grafts.
  • Excellent functional outcomes and patient satisfaction are achievable despite initial postoperative flexion contracture.
  • This method provides a viable alternative to graft augmentation for chronic avulsions.