title: A functional analysis of distal biceps tendon repair: single-incision Endobutton technique vs. two-incision modified Boyd-Anderson technique.
abstract: BACKGROUND
  The optimal surgical technique for a distal biceps tendon rupture repair still remains controversial. Current biomechanical evidence shows Endobutton fixation to have the highest load-to-failure testing, but clinical results of this are limited. The purpose of this study was to compare patient-oriented functional outcome between a modified Boyd-Anderson two-incision technique and repair with a single-incision Endobutton technique.
  
  
  METHODS
  All patients who underwent distal biceps tendon repair with a two-incision or Endobutton technique between 2000 and 2010 with two-year follow-up at our institution were identified. Their clinical, operative, and follow-up data was collected and analyzed. The primary outcome was a patient-oriented functional outcome measure (Disabilities of the Arm, Shoulder, and Hand: DASH). Secondary outcomes were evaluated using a subjective questionnaire.
  
  
  RESULTS
  Thirty-three patients were repaired with the two-incision technique and twenty-five patients had a repair with a single incision Endobutton technique. All patients receiving the two-incision repair were male, while there were 2 females who had an Endobutton procedure. There was no significant difference between the two-incision and the Endobutton groups in regards to mean DASH score (6.31 versus 5.91, p = 0.697), mean Work DASH score (10.49 versus 0.93, p = 0.166), and mean Sports DASH score (10.54 versus 9.56, p = 0.987). Regardless of technique, most patients were "extremely satisfied" (n = 42, or 72.41%) or "satisfied" (n = 10, or 17.24%) postoperatively, and returned to pre-operative activity in approximately 6 months (6.87 months versus 6.82 months, respectively) (p = 0.457). There was no significant difference in the prevalence of complications (39.39% versus 32.0%, respectively for two incision versus single incision) (p = 0.594).
  
  
  CONCLUSIONS
  Patients from both surgical groups were satisfied with their post-operative function and had similar functional outcomes and complication rates. Both surgical techniques for distal biceps tendon repair are effective and are similarly safe methods of treatment.
authors.affiliation: a Department of Orthopedic Surgery, Rothman Institute , Thomas Jefferson University Hospital , Philadelphia , PA , USA.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Cohen
authors.affiliation: a Department of Orthopedic Surgery, Rothman Institute , Thomas Jefferson University Hospital , Philadelphia , PA , USA.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Buckley
authors.affiliation: a Department of Orthopedic Surgery, Rothman Institute , Thomas Jefferson University Hospital , Philadelphia , PA , USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Neuman
authors.affiliation: a Department of Orthopedic Surgery, Rothman Institute , Thomas Jefferson University Hospital , Philadelphia , PA , USA.
authors.forename: J Martin
authors.initials: JM
authors.lastname: Leland
authors.affiliation: a Department of Orthopedic Surgery, Rothman Institute , Thomas Jefferson University Hospital , Philadelphia , PA , USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Ciccotti
authors.affiliation: a Department of Orthopedic Surgery, Rothman Institute , Thomas Jefferson University Hospital , Philadelphia , PA , USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Lazarus
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012421:Rupture / Q000601:surgery; D011795:Surveys and Questionnaires; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
keywords: Biceps; Distal; Endobutton; Repair; Rupture; Technique