APEX Elbow Mastering Surgical Techniques for Clinical Success-Distal Biceps Tendon Tears, Repairs, and Reconstruction

Video Transcription

Video Summary

Dr. Gus Mazzocca provides a comprehensive overview of distal biceps tendon ruptures, covering anatomy, biomechanics, diagnosis, treatment options, and surgical techniques. Distal biceps ruptures, often from eccentric contraction in middle-aged men, involve the tendon inserting on the ulnar side of the radial tuberosity with a 90-degree twist, crucial for supination function. Diagnosis includes the hook test and MRI imaging, with the FABS view offering optimal visualization. Non-operative treatment yields acceptable functional outcomes in low-demand patients, with minor strength loss mostly in supination endurance. However, surgical repair is preferred for active patients, acute ruptures, chronic tears with weakness, using either single or double incision techniques based on surgeon preference. Dr. Mazzocca favors a combined cortical button and interference screw repair, which biomechanically shows superior fixation and reduced displacement. He details his surgical approach emphasizing careful nerve protection, tendon preparation, and fixation with early active range of motion to minimize stiffness and heterotopic ossification. In chronic or complex cases, graft augmentation with dermal, Achilles, or semitendinosus allografts may be used. Complications are mainly minor nerve palsies and occasional heterotopic ossification. The talk underscores the importance of anatomy and technique in optimizing outcomes for distal biceps tendon repair.

Asset Caption

Augustus D. Mazzocca, MD, MS

Keywords

distal biceps tendon rupture

anatomy and biomechanics

diagnosis and imaging

non-operative treatment

surgical repair techniques

cortical button and interference screw

postoperative rehabilitation