Distal Biceps Tendon Repair Using a Double Tension Slide Technique.
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ABSTRACT:
SUBMITTER: Sochacki KR
PROVIDER: S-EPMC7253794 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Distal biceps tendon ruptures are uncommon and generally occur in men aged 30 to 50 years in their dominant arm as a result of a strong eccentric load. Numerous surgical exposures and methods of fixation exist for repair of a ruptured distal biceps tendon. The goal of surgical management is to restore the anatomic footprint of the biceps tendon on the radial tuberosity to maximize flexion strength, supination strength, and muscle endurance. When compared with 2-incision repair techniques, single-incision repairs historically may not have restored the anatomic footprint of the distal biceps. Single-incision repair with the ArthroTunneler is a safe and effective technique that provides the anatomic restoration of a 2-incision approach with the decreased complication profile of a single-incision approach and does not require suture anchors, buttons, screws, or other implants.
| S-EPMC5621039 | biostudies-literature
Project description:There are several techniques that have been described for distal biceps tendon repair but there is still controversy regarding the optimal technique. Our hypothesis is that the single-incision technique will have a similar complication rate and functionally equivalent restoration of function compared with the two-incision approach. A retrospective review of consecutive biceps tendon repairs was performed at one institution over a 5-year period. Thirty-six patients met the inclusion criteria and 26 were available for follow-up including subjective assessment, physical examination, and strength testing. Patients were divided into two groups based on the surgical approach utilized: 12 patients underwent single-incision repair and 14 had a two-incision repair. The average follow-up was 33 months (minimum 13; maximum 75). There were no statistically significant differences in regards to flexion strength or endurance, supination strength or endurance, or complication rates between the two techniques. In conclusion, both surgical techniques led to adequate restoration of strength with a low complication rate. Both techniques are safe to perform and should be guided by surgeon comfort with the approach.
| S-EPMC2553175 | biostudies-other
Project description:Distal biceps tendon ruptures are uncommon injuries that can cause impairment in range of motion and function. While distal bicep tendon repair to the radial tuberosity has been demonstrated to restore function and strength, there is a lack of consensus on the optimal technique. The purpose of this Technical Note and video is to provide our preferred method of repair using an open, onlay-tissue fixation with all-suture anchors (FiberTak; Arthrex) and anatomic positioning of the biceps tendon on the radial tuberosity.
| S-EPMC7587611 | biostudies-literature
Project description:Patients who experience distal biceps tendon avulsions generally benefit from surgical intervention. Compared with nonoperative treatment, surgery has shown improved muscle endurance as well as increased flexion and supination strength. Although a number of surgical techniques exist, repair of the distal biceps through a single incision is gaining popularity. This may be due in part to patient preference and emerging technologies such as cortical button fixation, suture anchors, and intraosseous screws. In this report, we present a simple technique for anatomically repairing distal biceps injuries using an intramedullary tenodesis button. This technique has the benefit of using a single unicortical drill hole in the radius while allowing the surgeon to sequentially tighten the tendon to its desired level of tension. When appropriate surgical steps are followed, it can be completed in a reliable, safe, and efficient manner through a single incision.
| S-EPMC4913031 | biostudies-literature
Project description:Distal biceps tendon ruptures are treated operatively in active healthy individuals. Treatment consists of either single- or double-incision techniques, each with its own set of advantages and complications. The double incision was traditionally preferred for a more anatomic reattachment of the distal biceps tendon, but there has been renewed interest in the single-incision anterior approach given its lower risk for heterotopic ossification. However, current single-incision techniques cannot achieve anatomic reconstruction of the distal biceps because of a restricted operational angle with standard rigid instruments. The purpose of this study was to introduce a single-incision technique using flexible instrumentation, flexible guide pins, and flexible reamers that allows for an insertion point that better approximates the anatomic footprint of the distal biceps on the tuberosity. This offers the theoretical advantage of restoring forearm supination mechanics, while still maintaining the benefits of a single limited anterior exposure.
| S-EPMC5851527 | biostudies-literature
Project description:IntroductionThe simultaneous rupture of both distal biceps tendons is a rare clinical entity that is difficult to treat and can have poor outcomes. A variety of treatment and rehabilitation options exist and have been reported for single sided and staged bilateral repairs, but none have described an approach for acute bilateral ruptures. Repairing distal biceps tendon ruptures using a single anterior incision and a cortical suspensory button technique has become increasingly popular in recent years. We present a report of our surgical approach using an endobutton technique and rehabilitation algorithm for this unusual injury pattern.Case presentationA 43-year-old Caucasian man presented with acute onset bilateral elbow pain while lifting a large sheet of drywall off the ground. He initially felt a 'pop' on the right and almost immediately felt another on the left after having to quickly shift the weight. He was unable to continue working and sought medical attention. His pain was predominantly in his bilateral antecubital fossae and he had significant swelling and ecchymoses. His clinical examination demonstrated no palpable tendon, a retracted biceps muscle belly, and clear supination weakness. Magnetic resonance imaging was performed and showed bilateral distal biceps tendon ruptures with retraction on both sides. After discussion with our patient, we decided that both sides would be repaired using a single anterior incision with endobutton fixation, first his right followed by his left six weeks later.ConclusionOverall, our patient did very well and had returned to full manual work by our last follow-up at 30 months. Although he was never able to return to competitive recreational hockey and was left with mild lateral antebrachial cutaneous nerve dysesthesias on his right, he felt he was at 85% of his premorbid level of function. We describe what we believe to be, to the best of our knowledge, the first case of simultaneous bilateral distal biceps tendon ruptures successfully treated with a single-incision endobutton technique, which represents a valid option in managing this difficult problem.
| S-EPMC3766066 | biostudies-literature
Project description:Distal biceps tendon ruptures are uncommon injuries responsible for only 3% of all injuries to the biceps tendon. For most of these cases, unless the patient is elderly or infirm, conservative management should be avoided and the injury should be treated with a surgical procedure to reattach the bicep tendon to the radial tuberosity. In this Technical Note and accompanying video, we describe an anatomic single-incision technique using 2 intramedullary soft anchors, which decreases the likelihood of complications associated with bicortical drilling and metal suspensory fixation.
| S-EPMC6262245 | biostudies-literature
Project description:Many therapies have been developed for patients with mass rotator cuff tears. Partial repair is often performed in patients with partially repairable massive rotator cuff tears because it is simpler to perform than superior capsule reconstruction. It may, however, result in rotator cuff retears frequently. This article presents our modified technique of arthroscopic partial reconstruction of the superior capsule using the long head of the biceps tendon with a biceps interposition.
| S-EPMC7301214 | biostudies-literature
Project description:Irreparable distal biceps tendon tears typically are treated using a free tendon graft. We asked whether our new method to fix the graft--using two suture anchors--yields similar results to our previous bone canal method. We compared the two methods for strength, endurance, and clinical findings. There were two groups, the suture anchor group (Group A, seven patients) and the bone canal group operated on before suture anchors (Group B, seven patients). The patients were males with a mean age at surgery of 44.9 years. The operative delay from primary trauma to index surgery averaged 5.9 months. The minimum followup was 2 years (mean, 11.1 years; range, 2-23 years). The mean arc of elbow motion was 0 degrees to 132 degrees, pronation 83 degrees, and supination 80 degrees. Compared with the contralateral side, the maximal peak torque was 84% in supination and 91% in pronation, and the maximal static elbow flexion strength was 94%. The Mayo elbow score averaged 99 in Group A and 100 in Group B. There were no major differences between the two groups. Our novel modification to fix a tendon graft yields equal clinical outcomes compared with the bone canal method for treatment of irreparable distal biceps tendon injuries.Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
| S-EPMC2584289 | biostudies-other
Project description:Tenodesis of the long head of the biceps tendon (LHB) at the upper part of the bicipital groove has been related to persistent postoperative bicipital pain. This is possibly due to the inflammation of the remaining tendon within the groove. This, in turn, could be attributed to the continual mechanical stress placed on the tendon in the narrow bicipital groove. Theoretically, should the LHB be more "relaxed," the mechanical stress applied on it would be diminished. On the basis of this rationale, we present an arthroscopic biceps tenodesis technique, according to which the tendon is fixed at the entrance of the bicipital groove, using a bioabsorbable screw, relaxed by 5 mm. In this lax position, the residual LHB tension is expected to be decreased compared with the initial tension, whereas no cosmetic deformity (Popeye sign) or impaired muscular performance is anticipated.
| S-EPMC4246411 | biostudies-other