title: Anatomical refixation for acute ruptures of the distal biceps tendon using a novel transcortical refixation system.
abstract: BACKGROUND
  In this study, minimally invasive CurvTek refixation is introduced as a novel approach for repair of distal biceps tendon ruptures. Exploration at the radial tuberosity is minimized using CurvTek, thereby reducing operative trauma. Treatment outcomes were compared for this technique against the conventional technique. In addition, we introduce position-dependent isometric myometry to allow quantitative measures of post-operative strength at specific elbow joint positions, for improved comparative analyses.
  
  
  METHODS
  Eighteen patients were included in this study and the mean follow-up was 17.6 months (range 6-35, SD +/- 6.9). Nine patients underwent conventional anatomical refixation, while the remaining nine patients underwent anatomical refixation using CurvTek-sutures. Clinical results and position-dependent strength were compared.
  
  
  RESULTS
  Mean age was 49.8 years (range 38-61; SD +/- 5.8). The average EFA-score was 82.2 (range 61-97; SD +/- 9.8). The CurvTek group scored a mean 87.0 (range 77-97; SD +/- 7.0) and the conventional anatomical refixation group a mean 77.4 (range 61-93; SD +/- 10.2) (P = 0.091). Position-dependent dynamic myometry revealed a loss of strength at end stage flexion and supination in the injured arm. Comparison of the two groups, revealed a statistically significant improvement in relative supination strength in the maximally supinated position for patients of the CurvTek group over those undergoing conventional refixation (P = 0.009).
  
  
  CONCLUSIONS
  Our results show that the CurvTek system leads to good post-operative strength and ROM without increasing the complication rate.
authors.affiliation: Department for Orthopedic and Trauma Surgery, University Hospital Freiburg, Hugstetter Strasse 55, Freiburg i. Br, Germany. PhNiemeyer@aol.com
authors.forename: Philipp
authors.initials: P
authors.lastname: Niemeyer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Köstler
authors.forename: Thorsten
authors.initials: T
authors.lastname: Bley
authors.forename: Heike
authors.initials: H
authors.lastname: Göbel
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Brook
authors.forename: Norbert P
authors.initials: NP
authors.lastname: Südkamp
authors.forename: Peter C
authors.initials: PC
authors.lastname: Strohm
mesh_terms: D000328:Adult; D001132:Arm; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000293:injuries / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D016059:Range of Motion, Articular; D012421:Rupture / Q000601:surgery; D013484:Supination; D013708:Tendon Injuries / Q000601:surgery*