AANA Elbow Arthroscopy - August 2024-Distal Biceps Tendon Tears, Repairs, and Reconstruction

Video Transcription

Video Summary

Dr. Gus Mazzocca discusses distal biceps tendon ruptures, reviewing anatomy, biomechanics, diagnosis, non-operative and surgical treatments, and complications. Distal biceps ruptures occur mostly in middle-aged men due to eccentric contractions, with a tendon insertion on the ulnar side of the radial tuberosity that twists about 90 degrees. Diagnosis includes physical exam signs like the Popeye deformity and the hook test, along with imaging such as MRI and specialized radiographic views. Non-operative treatment can yield acceptable functional outcomes, mainly affecting supination endurance, but some patients benefit from surgery, especially in acute ruptures or significant weakness.<br /><br />Surgical repair techniques vary, including single or double incision, with methods like suture anchors, cortical buttons, bone tunnels, and interference screws. Dr. Mazzocca favors combining a cortical button and interference screw for strong repair and minimal displacement, placing the screw on the radial side to anatomically press the tendon to the ulnar side. Early postoperative range of motion reduces stiffness and complications. In chronic or retracted tears, dermal or Achilles allografts may be used for augmentation. Complications are mainly nerve-related, especially lateral antebrachial cutaneous nerve palsy, with careful surgical technique protecting the posterior interosseous nerve.<br /><br />Overall, outcomes are good with appropriate technique and rehabilitation, emphasizing individualized treatment based on timing, tissue quality, and patient needs.

Keywords

distal biceps tendon rupture

anatomy and biomechanics

diagnosis techniques

non-operative treatment

surgical repair methods

postoperative rehabilitation

surgical complications