title: Distal biceps tendon rupture: current concepts.
abstract: BACKGROUND
  Distal biceps tendon rupture is not a very common injury and the literature remains scarce, mainly limited to case series. While surgical repair has become popular, it is not universally accepted and there are insufficient data regarding patient satisfaction following repair. The purpose of this study was to assess the results of anatomical reinsertion according to objective muscle strength testing and patient-reported outcome measures.
  
  
  METHODS
  Twenty-four patients underwent surgical repair over the last 10 years. All patients underwent clinical assessment using the Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder and Hand (DASH) score and Oxford Elbow score. Measurement of range of motion, supination and flexion strength testing was done using a Biodex isokinetic dynamometer.
  
  
  RESULTS
  Ninety-five percent of the patients had good or excellent results following surgery as defined by Mayo and Oxford Elbow scores. The average DASH score following surgery was 7.1, nearly the same as the score of 6.2 in the normal population. The mean elbow flexion arc was 134° ± 10.8 (range, 125-150°; 95% confidence interval (CI) 129.6-137.8) with no flexion contractures in the operated side compared with the unaffected elbow. The range of pronation-supination was also comparable in both sides. The average torque in flexion improved by 19.8% (p = 0.25) while supination torque was reduced by 4% (p = 0.12) when compared to the uninjured side. There was 8% incidence of persistent neuropraxia of the antebrachial cutaneous nerve of the forearm and 4% incidence of asymptomatic heterotopic ossification.
  
  
  CONCLUSIONS
  Surgical repair of distal biceps ruptures provides consistently good results in terms of patient-scored outcomes. Objective muscle strength testing does not reveal statistical difference between the injured and the opposite side.
authors.affiliation: University Hospital of NorthTees, Stockton on Tees, UK. shipra22@gmail.com
authors.forename: Praveen
authors.initials: P
authors.lastname: Sarda
authors.forename: Asaad
authors.initials: A
authors.lastname: Qaddori
authors.forename: Femke
authors.initials: F
authors.lastname: Nauschutz
authors.forename: Lesley
authors.initials: L
authors.lastname: Boulton
authors.forename: Rajesh
authors.initials: R
authors.lastname: Nanda
authors.forename: Neil
authors.initials: N
authors.lastname: Bayliss
mesh_terms: D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007103:Immobilization; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D009999:Ossification, Heterotopic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D011403:Pronation; D016059:Range of Motion, Articular; D012421:Rupture / Q000601:surgery; D057566:Self Report; D013484:Supination; D053441:Suture Anchors; D013708:Tendon Injuries / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D019415:Torque; D016896:Treatment Outcome