title: Radiological and Clinical Evaluation of the Transosseous Cortical Button Technique in Distal Biceps Tendon Repair.
abstract: OBJECTIVE
  One of the options to repair a ruptured distal biceps tendon to the radial tuberosity is by means of a transosseous cortical button. Although excellent functional outcomes have been reported, no studies have been performed to quantify the effect of the transosseous fixation technique on the radius. Our study evaluated the clinical outcome and radiological outcome of this technique. The main goal of this study was to evaluate the radiographic evolution of the bone tunnel in the radius.
  
  
  METHODS
  Patients with an acute distal biceps tendon rupture treated with a transosseous cortical button were invited to take part in the study. Fourteen patients were included in the final analysis. All patients were evaluated both clinically and by computed tomography scanning of the proximal radius after a minimum follow-up of 2 years. Outcomes were recorded using the visual analog scale score for pain, the Mayo Elbow Performance Score, and Disabilities of the Arm, Shoulder, and Hand scores. Bone tunnel volume was measured with semiautomated computed tomography segmentation using image-processing software.
  
  
  RESULTS
  There were no failures of fixation in the patient group examined. Elbow mobility, arm, and forearm circumference were symmetric for all patients. Average visual analog scale for pain was less than 2. Mean Disabilities of the Arm, Shoulder, and Hand score and Mayo Elbow Performance Score were 2.3 and 97.6, respectively. Computed tomography images showed an average closure of the radial bony tunnel of 64% of the initial volume.
  
  
  CONCLUSIONS
  Biceps tendon repair with cortical button fixation only shows partial tunnel closure. This could reduce the risk of potential complications due to osteolysis, such as radius fracture or hardware failure. Functional results were excellent and comparable to other fixation methods. The role of interference screws in transosseous cortical button techniques to strengthen the repair and to avoid osteolysis may therefore be questioned.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, AZ Monica Deurne, Deurne, Belgium. Electronic address: Caekebeke.pieter@hotmail.com.
authors.forename: Pieter
authors.initials: P
authors.lastname: Caekebeke
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, AZ Monica Deurne, Deurne, Belgium.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Vermeersch
authors.affiliation: Orthopaedic Department, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Joris
authors.initials: J
authors.lastname: Duerinckx
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, AZ Monica Deurne, Deurne, Belgium.
authors.forename: Roger
authors.initials: R
authors.lastname: van Riet
mesh_terms: D000328:Adult; D001134:Arm Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000293:injuries / Q000601:surgery; D015588:Observer Variation; D012189:Retrospective Studies; D012421:Rupture / Q000000981:diagnostic imaging / Q000601:surgery; D053441:Suture Anchors; D013536:Suture Techniques; D013708:Tendon Injuries / Q000000981:diagnostic imaging* / Q000601:surgery*; D053656:Tenodesis / Q000295:instrumentation* / Q000379:methods; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
keywords: Biceps tendon; osteolysis; radial bony tunnel; repair; transosseous cortical button