Distal Biceps Repair: 2-Volar Incision Technique for Acute and Chronic Retracted Tears.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Anatomy

Background:

• Distal biceps tendon ruptures typically affect middle-aged men, causing significant weakness in elbow flexion and forearm supination.
• Acute and chronic tears often require surgical repair to restore function, with chronic cases presenting challenges due to tendon retraction.

Purpose of the Study:

• To describe a minimally invasive, two-incision volar technique for distal biceps tendon repair.
• To evaluate the technique's efficacy in managing both acute and chronic retracted tears, with or without graft reconstruction.

Main Methods:

• A volar two-incision technique is employed, with one incision over the radial tuberosity for tendon reattachment and a second proximal incision for tendon retrieval.
• The retracted tendon is retrieved, prepared, or reconstructed with a graft for chronic tears, then tunneled between incisions.
• Fixation is achieved using a suture button and interference screw construct for anatomical restoration.

Main Results:

• The technique minimizes skin incision length and extensive dissection, optimizing exposure of critical anatomical structures.
• It facilitates accurate anatomical restoration and effective visualization, even in chronic tears with significant tendon retraction.
• Restoration of distal biceps function is achieved without requiring extensive volar exposure.

Conclusions:

• The described two-incision volar technique offers a less invasive approach to distal biceps repair.
• It provides excellent visualization and anatomical restoration for acute and chronic tears, including those requiring graft reconstruction.
• This method mitigates the need for extensive dissection and improves outcomes for challenging cases.