title: Endobutton versus transosseous suture repair of distal biceps rupture using the two-incision technique: a comparison series.
abstract: BACKGROUND
  The purpose of this study was to report the outcome of a large cohort of patients undergoing distal biceps tendon repair. We compared the endobutton and transosseous suture repair techniques, both performed through a 2-incision approach.
  
  
  METHODS
  At an average of 2.1 years after a distal biceps repair, 46 male patients (19 endobutton and 27 transosseous suture) were reviewed. The mean age of our patients was 50 years.
  
  
  RESULTS
  Forty-three patients (93%) were satisfied with the results of their distal biceps tendon repair. The average pain score was 1.3 of 10 at a mean 2.1 years after repair. More than 80% of patients had regained their premorbid function in both recreational and occupational activities. The mean Mayo Elbow Performance Score was 93 of 100. Biodex strength testing demonstrated restoration of 92% of low-velocity supination power, 102% of high-velocity supination power, and 104% endurance compared with the contralateral limb. There was no statistically significant difference in postoperative strength between the transosseous suture and endobutton groups. There were 3 complications in this series, 1 case of heterotopic ossification and 2 cases of injury to the lateral cutaneous nerve of the forearm.
  
  
  CONCLUSIONS
  In this large cohort of 2-incision distal biceps repairs, we found a high degree of patient satisfaction and a low complication rate. We did not find any difference in clinical outcome with regard to subjective patient rating, pain, range of motion, or supination strength when comparing the 2-incision endobutton and transosseous suture fixation techniques.
authors: Orthopaedics, North Shore Hospital, Waitemata District Health Board, Auckland, New Zealand. Electronic address: james.recordon@waitematadhb.govt.nz.
authors: James A F
authors: JA
authors: Recordon
authors: Orthopaedics, North Shore Hospital, Waitemata District Health Board, Auckland, New Zealand.
authors: Peter N
authors: PN
authors: Misur
authors: Orthopaedics, North Shore Hospital, Waitemata District Health Board, Auckland, New Zealand.
authors: Fredrik
authors: F
authors: Isaksson
authors: Orthopaedics, North Shore Hospital, Waitemata District Health Board, Auckland, New Zealand.
authors: Peter C
authors: PC
authors: Poon
mesh_terms: D000328:Adult; D000368:Aged; D004551:Elbow Joint; D005260:Female; D005542:Forearm; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000293:injuries*; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D012421:Rupture / Q000601:surgery; D013484:Supination; D013536:Suture Techniques / Q000009:adverse effects; D013708:Tendon Injuries / Q000601:surgery*
keywords: Biodex; Distal biceps repair; endobutton; two-incision