title: Anatomic findings and complications after surgical treatment of chronic, partial distal biceps tendon tears: a case cohort comparison study.
abstract: OBJECTIVE
  To describe pertinent anatomic findings during repair of chronic, partial distal biceps tendon tears and to compare the complications of surgery with a similar cohort of acute, complete tears.
  
  
  METHODS
  Group 1 included 14 patients (15 elbows) with partial tears managed operatively an average of 10 months from onset of injury or symptoms. Group 2 included a matched cohort of 16 patients (17 elbows) treated for complete, acute tears an average of 19 days from injury. A retrospective review of all 30 patients focused on demographic data, intraoperative findings, and postoperative complications. A single, anterior incision was used in all cases with multiple suture anchors or a bicortical toggling button for fixation of the repair.
  
  
  RESULTS
  We evaluated 27 men and 3 women with an average age of 55 years (group 1) and 48 years (group 2). Intratendinous ganglion formation at the site of rupture of the degenerative tendon was observed in 5 cases of partial tears and none of the complete tears. Partial tears involved the lateral aspect or short head of the biceps tendon insertion in all cases. Postoperative complications included lateral antebrachial cutaneous nerve neuritis in 8 group 1 patients and 6 group 2 patients and transient posterior interosseus nerve palsy in 3 group 1 patients.
  
  
  CONCLUSIONS
  Partial distal biceps tendon ruptures showed a consistent pattern of pathology involving disruption of the lateral side of the tendon insertion involving the small head of the biceps. Degenerative intratendinous ganglion formation was present in one third of cases. Repair of chronic, partial distal biceps tendon injuries may have a higher incidence of posterior interosseous and lateral antebrachial cutaneous nerve palsies.
  
  
  METHODS
  Therapeutic III.
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC; South Carolina Sports Medicine and Orthopaedic Center, Charleston, SC.
authors.forename: David S
authors.initials: DS
authors.lastname: Ruch
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC; South Carolina Sports Medicine and Orthopaedic Center, Charleston, SC. Electronic address: tyler.watters@dm.duke.edu.
authors.forename: Tyler Steven
authors.initials: TS
authors.lastname: Watters
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC; South Carolina Sports Medicine and Orthopaedic Center, Charleston, SC.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Wartinbee
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC; South Carolina Sports Medicine and Orthopaedic Center, Charleston, SC.
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Richard
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC; South Carolina Sports Medicine and Orthopaedic Center, Charleston, SC.
authors.forename: Fraser J
authors.initials: FJ
authors.lastname: Leversedge
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC; South Carolina Sports Medicine and Orthopaedic Center, Charleston, SC.
authors.forename: Suhail K
authors.initials: SK
authors.lastname: Mithani
mesh_terms: D000328:Adult; D000368:Aged; D001134:Arm Injuries / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects; D059348:Peripheral Nerve Injuries / Q000209:etiology; D012189:Retrospective Studies; D012421:Rupture; D013708:Tendon Injuries / Q000473:pathology / Q000601:surgery*
keywords: Chronic tear; distal biceps; partial tear; repair