title: Anatomic reinsertion of the distal biceps tendon rupture through a single anterior approach: extensile or mini-invasive approach? A retrospective study at mean 45-month follow-up.
abstract: OBJECTIVE
  To evaluate and compare clinical results and complication rate of a standard and mini-invasive reconstruction technique for distal biceps tendon rupture.
  
  
  METHODS
  Twenty-eight cases of biceps tendon rupture were evaluated at mean 45-month follow-up. A standard anterior approach was used in 19 cases, and a less invasive anterior approach was used in nine cases. Suture anchors were used for tendon reconstruction in all cases. Elbow range of motion (ROM), subjective strength recovery, time to return to work and sports activities, and complications were recorded. Disability of the Arm, Shoulder and Hand Score (DASH) the Oxford Elbow Score (OES), and the Mayo Elbow Performance Score (MEPS) were obtained for all patients.
  
  
  RESULTS
  Mean ROM recovery was almost complete. Mean subjective strength recovery allowed full return to sports and work in 93 % of cases, within mean 3-month postoperative. Mean DASH, OES, and MEPS scores were good. The clinically relevant complications rate was 17.8 %, all associated with the standard extensile approach group (Group A). Asymptomatic heterotopic ossifications were detected in four cases (14.3 %), not affecting functional recovery.
  
  
  CONCLUSIONS
  Clinical results and complications rate of anatomical reconstruction of the distal biceps tendon rupture were comparable to the literature. Comparison between Group A and B showed no significant differences in terms of ROM, and OES and MEPS scores. Strength recovery, time to return to sports and work, and DASH score showed a positive trend in Group B. The clinically relevant complications rate was 0 % in Group B and 26 % in Group A.
authors.affiliation: Department of Orthopaedics and Traumatology, University of Insubria, Ospedale di Circolo, Viale Borri 57, Varese, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Murena
authors.affiliation: Department of Orthopaedics and Traumatology, University of Insubria, Ospedale di Circolo, Viale Borri 57, Varese, Italy. gcanton84@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Canton
authors.affiliation: Department of Orthopaedics and Traumatology, University of Insubria, Ospedale di Circolo, Viale Borri 57, Varese, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Camana
authors.affiliation: Department of Orthopaedics and Traumatology, University of Insubria, Ospedale di Circolo, Viale Borri 57, Varese, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Vulcano
authors.affiliation: Department of Orthopaedics and Traumatology, University of Insubria, Ospedale di Circolo, Viale Borri 57, Varese, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Cherubino
mesh_terms: D000328:Adult; D000368:Aged; D004551:Elbow Joint / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000293:injuries; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012421:Rupture; D053441:Suture Anchors; D013536:Suture Techniques; D013708:Tendon Injuries / Q000175:diagnosis / Q000601:surgery*; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D000092464:Elbow Injuries
keywords: Anterior approach; Biceps repair; Biceps rupture; Biceps tendon; Mini-invasive; Suture anchors