title: Distal biceps tendon rupture reconstruction using muscle-splitting double-incision approach.
abstract: OBJECTIVE
  To evaluate the clinical and functional results after repair of distal biceps tendon tears, following the Morrey's modified double-incision approach.
  
  
  METHODS
  We retrospectively reviewed 47 patients with distal rupture of biceps brachii treated between 2003 and 2012 in our Orthopedic Department with muscle-splitting double-incision technique. Outcome measures included the Mayo elbow performance, the DASH questionnaire, patient's satisfaction, elbow and forearm motion, grip strength and complications occurrence.
  
  
  RESULTS
  At an average 18 mo follow-up (range, 7 mo-10 years) the average Mayo elbow performance and DASH score were respectively 97.2 and 4.8. The elbow flexion range was 94%, extension was -2°, supination was 93% and pronation 96% compared with the uninjured limb. The mean grip strength, expressed as percentage of respective contralateral limb, was 83%. The average patient satisfaction rating on a Likert scale (from 0 to 10) was 9.4. The following complications were observed: 3 cases of heterotopic ossification (6.4%), one (2.1%) re-rupture of the tendon at the site of reattachment and 2 cases (4.3%) of posterior interosseous nerve palsy. No complication required further surgical treatment.
  
  
  CONCLUSIONS
  This technique allows an anatomic reattachment of distal biceps tendon at the radial tuberosity providing full functional recovery with low complication rate.
authors.affiliation: Luigi Tarallo, Raffaele Mugnai, Francesco Zambianchi, Fabio Catani, Orthopaedics and Traumatology Department, Modena Policlinic, University of Modena and Reggio Emilia, 41124 Modena, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Tarallo
authors.affiliation: Luigi Tarallo, Raffaele Mugnai, Francesco Zambianchi, Fabio Catani, Orthopaedics and Traumatology Department, Modena Policlinic, University of Modena and Reggio Emilia, 41124 Modena, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Mugnai
authors.affiliation: Luigi Tarallo, Raffaele Mugnai, Francesco Zambianchi, Fabio Catani, Orthopaedics and Traumatology Department, Modena Policlinic, University of Modena and Reggio Emilia, 41124 Modena, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Zambianchi
authors.affiliation: Luigi Tarallo, Raffaele Mugnai, Francesco Zambianchi, Fabio Catani, Orthopaedics and Traumatology Department, Modena Policlinic, University of Modena and Reggio Emilia, 41124 Modena, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Adani
authors.affiliation: Luigi Tarallo, Raffaele Mugnai, Francesco Zambianchi, Fabio Catani, Orthopaedics and Traumatology Department, Modena Policlinic, University of Modena and Reggio Emilia, 41124 Modena, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Catani
keywords: Clinical outcome; Complications; Distal biceps tendon; Double incision; Morrey; Rupture; Trans-osseous tunnels