title: Distal biceps brachii tendon repairs: a single-incision technique using a cortical button with interference screw versus a double-incision technique using suture fixation through bone tunnels.
abstract: BACKGROUND
  Distal biceps brachii tendon repairs performed with a tension slide technique using a cortical button (CB) and interference screw are stronger than those based on suture fixation through bone tunnels (BTs) in biomechanical studies. However, clinical comparison of these 2 techniques is lacking in the literature.
  
  
  OBJECTIVE
  To perform a clinical comparison of the single-incision CB and double-incision BT techniques.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  Distal biceps tendon ruptures repaired through either the single-incision CB or double-incision BT technique were retrospectively identified at a single institution. Patients>1 year out from surgery were assessed for range of motion, strength, and complications, and they completed a DASH questionnaire (Disabilities of the Arm, Shoulder, and Hand).
  
  
  RESULTS
  Patients in the CB group (n=20) were older (52±9.5 vs 43.7±8.7 years; P=.008), had a shorter interval from surgery to evaluation (17.7±5 vs 30.8±16.5 months; P=.001), and were less likely to smoke (0% vs 28.5%; P=.02) compared with the BT patients (n=21). DASH scores were similar between groups (4.46±4.4 [CB] vs 5.7±7.5 [BT]; P=.65). Multivariate analysis revealed no differences in range of motion or strength between groups. More CB patients (30%; n=6) experienced a complication compared with those in the BT group (4.8%; n=1) (P=.04), and these complications were predominantly paresthesias of the superficial radial nerve that did not resolve. There were no reoperations or repair failures in either group.
  
  
  CONCLUSIONS
  Both the single-incision CB and double-incision BT techniques provided excellent clinical results. Complications were more common in the single-incision CB group and most commonly involved paresthesias of the superficial radial nerve.
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, New York, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Shields
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, New York, USA.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Olsen
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, New York, USA.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Williams
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, New York, USA.
authors.forename: Lucien
authors.initials: L
authors.lastname: Rouse
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, New York, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Maloney
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, New York, USA Ilya_Voloshin@urmc.rochester.edu.
authors.forename: Ilya
authors.initials: I
authors.lastname: Voloshin
mesh_terms: D000328:Adult; D000368:Aged; D001863:Bone Screws; D001842:Bone and Bones; D015331:Cohort Studies; D004550:Elbow / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D012421:Rupture / Q000601:surgery; D013537:Sutures; D013708:Tendon Injuries / Q000601:surgery*; D013710:Tendons / Q000601:surgery*
keywords: cortical button; distal biceps brachii tendon repair; double incision; interference screw; single incision; suture anchor