[Repair of distal biceps brachii tendon ruptures: long term retrospective follow-up for two-incision technique].
BACKGROUND
Rupture of the distal tendon of the biceps muscle is a rare injury. If unrepaired the patient will be left with weakness of supination of the arm and flexion in the elbow. Long term results for the 2-incision approach for tendon reinsertion are few but in this study we describe the long term, clinical, functional, and subjective results of surgical repair using the 2-incision method described by Boyd and Anderson.


METHODS
All patients who were operated at FSA hospital during the years 1986-2000 because of rupture of the distal tendon of the biceps muscle were asked to participate in the study. Twelve of 16 patients accepted and answered the DASH questionnaire. Strength was tested with handheld dynamometer and ROM where measured. Radiograph was taken of the affected arm.


RESULTS
From 1986 through 2006 we operated on 16 patients because of rupture of the distal biceps tendon, one female and 15 male. Mean age at the time of rupture was 46 years (24-53).The average follow up were seven years (1-17). Ten of 12 patients were operated within two weeks from the injuries. No difference in strength was found between operated and non-operated arms. Late repair was associated with high DASH score and poor subjective results. Six patients developed heterotopic ossification but none of them developed radioulnar synostosis. One reoperation because entrapment of the median nerve was done.


CONCLUSIONS
Despite heterotopic ossification and a small ROM deficit the Boyd and Anderson technique for repair of distal biceps ruptures yields good long term results in a low volume rural hospital. Early diagnosis and tendon reinsertion is of great importance to avoid persistent anterior elbow pain and poor subjective results.
Sigmundsson
Freyr Gauti
FG
Ortobediska Kliniken, Karlshamm och Karlskrona, Blekingesjukhuset, Karlshamm, Svibjoo, Iceland. freyr.gauti.sigmundsson@ltblekinge.se
Olafsson
Ari H
AH
Ingvarsson
Thorvaldur
T
D000328:Adult; D001134:Arm Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006780:Hospitals, Rural; D006801:Humans; D007055:Iceland; D008297:Male; D020423:Median Neuropathy / Q000209:etiology; D008875:Middle Aged; D053580:Muscle Strength; D009408:Nerve Compression Syndromes / Q000209:etiology; D009999:Ossification, Heterotopic / Q000209:etiology; D010146:Pain / Q000209:etiology; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D012421:Rupture; D011795:Surveys and Questionnaires; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013709:Tendon Transfer / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult