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Operative Versus Nonoperative Outcomes: A Cohort Study on Distal Biceps Tendon Rupture
Ahmad A Quzli1, Hassan Jouni2, Andrew P Dekker3
1Trauma and Orthopaedics, Wirral University Teaching Hospital NHS Foundation Trust, Wirral, GBR.
Cureus
|November 5, 2025
Summary
Surgical repair of distal biceps tendon ruptures offers greater strength recovery but increases complication risks. Nonoperative management provides good function with fewer risks, suggesting individualized treatment for these injuries.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Musculoskeletal Injuries
Background:
- Distal biceps tendon ruptures are common in middle-aged men after eccentric loading.
- Surgical repair is a frequent treatment, but comparative outcome data are scarce.
- This study evaluates operative versus nonoperative management for distal biceps tendon ruptures.
Purpose of the Study:
- To compare outcomes of operative and nonoperative management for complete distal biceps tendon ruptures.
- To assess complication rates, range of motion, and return to activity.
- To inform individualized treatment decisions based on patient profiles.
Main Methods:
- Retrospective review of 72 patients (2016-2023) with distal biceps tendon ruptures.
- 52 patients underwent operative repair (single or two-incision technique); 20 received nonoperative management.
- Data abstracted from clinical records included complications, range of motion, and return to activity.
Main Results:
- Operative management had higher complication rates (nerve injuries, wound issues) but good functional recovery.
- Nonoperative management had minimal complications and allowed return to previous activities with minor strength deficits.
- Operative repair yielded better strength recovery (especially supination) but increased morbidity.
Conclusions:
- Nonoperative management is a viable option for selected patients with distal biceps tendon ruptures.
- Operative repair is effective but carries a higher risk of complications.
- Treatment decisions should be individualized, considering patient activity, expectations, and risk tolerance.
