Avulsion of the distal biceps brachii tendon in middle-aged population: is surgical repair advisable? A comparative study of 22 patients treated with either nonoperative management or early anatomical repair.
BACKGROUND
Operative anatomical repair following complete avulsion of the distal biceps brachii tendon in athletic population is usually recommended. However, there is no clear consensus as to the advisability of the operation in middle-aged population. We therefore undertook a study to examine whether early anatomical repair in this specific population is preferable to nonoperative management.


METHODS
We evaluated the outcome at a mean of 2 years following this injury in a group of 22 middle-aged active men. Of this group, 12 were managed with early anatomical repair and 10 were managed nonoperatively. Our evaluation included subjective functional outcome scales, isokinetic measurements, and postoperative complication survey.


RESULTS
Although subjective functional assessment demonstrated higher satisfaction in the operated group (p<.05), 9 of the 10 nonoperated patients reported good to excellent outcome as well. Isokinetic evaluation revealed higher performance of elbow flexors and forearm supinators in the group managed operatively (p<.05), while two patients in this group suffered nerve injuries, though both resolved eventually.


CONCLUSIONS
Surgical repair of complete avulsion of the distal biceps brachii tendon in middle-aged active population may be advised to patients, as it achieves superior outcome both subjectively and objectively. However, nonoperative management should be seriously discussed with each patient, as it is expected to result in good to excellent outcome as well, while avoiding potential complications related to the surgery.
Hetsroni
Iftach
I
Orthopedic Department, Meir University Hospital, Sapir Medical Center, Kfar Saba, Israel. hetsrony@netvision.net.il
Pilz-Burstein
Ruth
R
Nyska
Meir
M
Back
Zipy
Z
Barchilon
Vidal
V
Mann
Gideon
G
D000328:Adult; D001134:Arm Injuries / Q000601:surgery / Q000628:therapy*; D004551:Elbow Joint / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012421:Rupture / Q000601:surgery / Q000628:therapy; D013484:Supination; D013708:Tendon Injuries / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome