title: Treatment of distal biceps tendon ruptures using a single-incision technique and a Bio-Tenodesis screw.
abstract: No consensus exists in the literature on the optimal operative treatment method for distal biceps tendon ruptures. It is our hypothesis that a single-incision technique with a poly-L-lactide Bio-Tenodesis screw (Arthrex, Inc, Naples, Florida) is a safe and effective method for operative management of distal biceps tendon ruptures, with success and complication rates comparable to previous reports in the literature. This article describes a prospective case series of 29 consecutive patients (30 operations) managed by the same surgeon over 34 months. Average follow-up was 19.6 months. Two patients were lost to follow-up. Elbow range of motion (ROM) and strength; Disabilities of the Arm, Shoulder, and Hand (DASH) score; and SF-12 score were measured at various time points up to 2 years. All patients had full extension and supination. Supination and flexion strength was at least 4/5 in all patients. Mean DASH, SF-12 Physical Component (PCS), and SF-12 Mental Component (MCS) scores were 5.86 (range, 0-16.67), 50.35 (range, 30.4-60.1), and 57.15 (range, 41.7-64.4), respectively. These scores are comparable to normative values reported by the American Academy of Orthopaedic Surgeons. Complication rates were similar to those previously reported in the literature. This type of fixation allowed for early mobilization of the operative arm. Our study demonstrates that use of a tenodesis screw for distal biceps repair results in DASH and SF-12 scores comparable to the norm for the general population with complications similar to those seen in past studies. In addition, biomechanical studies suggest that the repair is strong enough to allow early ROM, and the fixation technique may allow for more anatomic positioning of the distal biceps along the ulnar border of the bicipital tuberosity.
authors.affiliation: Department of Orthopedics, University of Massachusetts Medical School, Worcester, Massachusetts 01605, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Silva
authors.forename: Mark S
authors.initials: MS
authors.lastname: Eskander
authors.forename: Craig
authors.initials: C
authors.lastname: Lareau
authors.forename: Nicola A
authors.initials: NA
authors.lastname: DeAngelis
mesh_terms: D000328:Adult; D000368:Aged; D001134:Arm Injuries / Q000534:rehabilitation / Q000601:surgery*; D001863:Bone Screws; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D053580:Muscle Strength; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012421:Rupture; D053441:Suture Anchors; D013536:Suture Techniques; D013708:Tendon Injuries / Q000534:rehabilitation / Q000601:surgery*; D053656:Tenodesis / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome