Double-Incision Technique for the Treatment of Distal Biceps Tendon Rupture.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Reconstructive Surgery

Background:

• Distal biceps tendon ruptures require surgical repair for optimal functional recovery.
• The double-incision technique with bone-tunnel fixation allows for anatomical reattachment to the radial tuberosity.
• This method aims to restore elbow strength and motion while minimizing neurological complications.

Purpose of the Study:

• To evaluate the efficacy and safety of the double-incision technique for distal biceps tendon rupture repair.
• To compare the outcomes of the double-incision technique with the single-incision approach.
• To assess the rates of functional recovery, range of motion, and neurological complications.

Main Methods:

• The double-incision technique involves two incisions: one in the antecubital fossa and a second on the dorsal proximal forearm.
• The distal biceps tendon is whipstitched with high-resistance sutures and passed through bone tunnels in the radial tuberosity.
• Forearm position (pronation/supination) is used to protect specific nerves during dissection and fixation.

Main Results:

• A meta-analysis showed no significant difference in overall postoperative functional scores between single-incision and double-incision techniques.
• The double-incision technique demonstrated a significantly lower rate of neurological complications (13.4%) compared to the single-incision technique (24.5%).
• Specifically, the double-incision method showed a reduced risk of lateral antebrachial cutaneous nerve (LABCN) damage.

Conclusions:

• The double-incision technique is an effective and safe procedure for restoring elbow functionality after distal biceps tendon rupture.
• It offers a favorable safety profile regarding neurological complications, particularly for active patients.
• While functional scores may be similar, the reduced risk of nerve injury makes it a preferred option in certain patient populations.