title: The functional outcome of forty-nine single-incision suture anchor repairs for distal biceps tendon ruptures at the elbow.
abstract: OBJECTIVE
  The objective of this retrospective study was to evaluate the functional results of distal biceps tendon repair using suture anchors via a single-incision approach.
  
  
  METHODS
  Forty-nine patients were re-examined at a mean follow-up of 44.2 ± 32.1 months (range, 12-119 months). Subjective and objective criteria included patient's satisfaction, active range of motion (ROM), maximum isometric strength in flexion (at 45° and 90°), and supination of both arms. Functional scoring included the Morrey elbow score (MES) and the QuickDASH. Furthermore, follow-up radiographs were performed.
  
  
  RESULTS
  Eighty-six percent of patients were highly satisfied or satisfied with their outcome. Compared to contralateral, the active ROM of elbow flexion, extension, and pronation was not affected; however, supination was decreased by 3° (P < 0.001). The isometric maximum strengths showed significant deficits in all tested scenarios (at 45°, P = 0.002; at 90°, P < 0.001; for supination, P < 0.001). The MES and the QuickDASH were 97.2 ± 4.9 and 7.9 ± 13.9, respectively. Heterotopic ossifications (HO) were found in 39% of patients; however, with respect to scores and strength, no significant differences were seen compared to patients without HO. Moreover, four anchor failures were detected.
  
  
  CONCLUSIONS
  Single-incision suture anchor repair provides high patient's satisfaction and good results with respect to ROM and functional scoring. Nevertheless, based on presented data, the patient has to be informed of postoperative HO and especially for supination strength weakness after surgery. Distal biceps tendon repair should be reserved for experienced upper extremity surgeons to avoid procedure-related complications.
authors.affiliation: Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Str. 22, D-81675, Munich, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Siebenlist
authors.forename: Stephanie C
authors.initials: SC
authors.lastname: Fischer
authors.forename: Gunther H
authors.initials: GH
authors.lastname: Sandmann
authors.forename: Philipp
authors.initials: P
authors.lastname: Ahrens
authors.forename: Petra
authors.initials: P
authors.lastname: Wolf
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stöckle
authors.forename: Andreas B
authors.initials: AB
authors.lastname: Imhoff
authors.forename: Peter U
authors.initials: PU
authors.lastname: Brucker
mesh_terms: D000328:Adult; D000368:Aged; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D009999:Ossification, Heterotopic / Q000453:epidemiology / Q000503:physiopathology; D017060:Patient Satisfaction; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012421:Rupture; D013484:Supination; D053441:Suture Anchors; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult