title: Anatomic repair of the distal biceps tendon cannot be consistently performed through a classic single-incision suture anchor technique.
abstract: BACKGROUND
  Distal biceps tendon ruptures commonly occur in active men, and surgical repair through a single-incision technique using suture anchors has become common. The current study assessed whether an anatomic repair of the biceps to the radial tuberosity can be consistently achieved through a single-incision technique.
  
  
  METHODS
  Acute distal biceps tendon repairs using the single-incision technique were retrospectively reviewed. Computed tomography (CT) scans were obtained to investigate tuberosity dimensions and the position of the suture anchors. An isokinetic dynamometer was used to obtain flexion and supination strength. Disabilities of the Arm, Shoulder and Hand (DASH) scores were collected.
  
  
  RESULTS
  CT scans were performed in 27 patients, of which, 21 underwent strength testing. The suture anchor placement averaged 50° radial to the apex of the tuberosity. Strength testing showed flexion strength of the repaired side was equal (97%-106%) to the normal side. Supination strength (80%-86%) and work (66%-75%) performed were both weaker on the repaired side (66%-75%; P < .05). The average DASH score was 10.7.
  
  
  CONCLUSIONS
  Ideal suture anchor placement, in the ulnar aspect of the tuberosity, could not be reliably achieved through this single-incision technique. This could have clinical importance because supination strength was not fully restored in this group of patients.
authors.affiliation: Division of Orthopaedics, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada. Electronic address: ghansen76@gmail.com.
authors.forename: Gregory
authors.initials: G
authors.lastname: Hansen
authors.affiliation: School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Smith
authors.affiliation: Division of Orthopaedics, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
authors.forename: J Whitcomb
authors.initials: JW
authors.lastname: Pollock
authors.affiliation: Division of Orthopaedics, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Joel
authors.initials: J
authors.lastname: Werier
authors.affiliation: Department of Radiology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Nairn
authors.affiliation: Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Kawan S
authors.initials: KS
authors.lastname: Rakhra
authors.affiliation: School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Benoit
authors.affiliation: Division of Orthopaedics, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Steven
authors.initials: S
authors.lastname: Papp
mesh_terms: D000328:Adult; D000368:Aged; D001134:Arm Injuries / Q000601:surgery*; D004550:Elbow / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011884:Radius / Q000601:surgery; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012421:Rupture; D053441:Suture Anchors; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: CT scan; Distal biceps repair; biceps strength; single incision; suture anchor