title: Cross-sectional anatomy of the bicipital tuberosity and biceps brachii tendon insertion: relevance to anatomic tendon repair.
abstract: This study evaluated the insertional anatomy and orientation of the biceps tuberosity and tendon to assess the anatomic validity of repairs made with 1 incision vs 2 incisions. Computed axial tomography was used to image 30 cadaver radii, and each tendon insertion was measured with a digital micrometer. Specimens were sectioned and imaged with Faxitron radiography (Faxitron X-Ray Corp, Wheeling, IL) to determine the angular orientation of the biceps tendon insertion relative to the tuberosity apex. The tuberosity axis of orientation averaged 65 degrees (range, 15 degrees -120 degrees ) of pronation from anterior, with angular orientation encompassing a mean 59 degrees (range, 15 degrees -100 degrees ) arc with the midpoint of the insertion averaging 50 degrees (range, -5 degrees to 105 degrees ). Most biceps tendons inserted on the anterior aspect of the apex of the tuberosity, with an average width of 7 mm and length of 22 mm. The biceps tuberosity is oriented in more pronation than is typically described, prohibiting anatomic reinsertion of the tendon in 35% of specimens with current single-incision techniques.
authors.affiliation: Curtis National Hand Center, Baltimore, MD, USA.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Forthman
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Zimmerman
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sullivan
authors.forename: Gerard T
authors.initials: GT
authors.lastname: Gabel
mesh_terms: D019412:Anatomy, Cross-Sectional; D002102:Cadaver; D006801:Humans; D018482:Muscle, Skeletal / Q000033:anatomy & histology*; D011884:Radius / Q000000981:diagnostic imaging*; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology; D013710:Tendons / Q000033:anatomy & histology*; D014057:Tomography, X-Ray Computed