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Orthopaedics & Traumatology: Surgery & Research
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le jeudi 6 décembre 2018
Doi : 10.1016/j.otsr.2018.10.012
Received : 12 July 2018 ;  accepted : 5 October 2018
Double incision repair technique with immediate mobilization for acute distal biceps tendon ruptures provides good results after 2 years in active patients
 

Hugo Barret a, , Matthias Winter b, Olivier Gastaud c, David J. Saliken d, Marc Olivier Gauci a, Nicolas Bronsard a
a CHU Nice, 30, voie romaine, 06000 Nice, France 
b Clinique Saint-Jean, 06800 Cagnes sur mer, France 
c CH Cannes, 06800 Cannes, France 
d Orthopaedic surgery, Victoria BC, Canada 

Corresponding author.
Abstract
Introduction

Surgical treatment of distal biceps tendon ruptures is recommended in an active population to avoid loss of strength, especially in supination and flexion.

Hypothesis

A double incision repair technique with immediate postoperative mobilization for acute distal biceps tendon ruptures is safe and provides good results after 2 years in active patients.

Material and methods

Seventy-four men (47±7 years) with acute tears of the distal biceps tendon tears were included in this retrospective single-center study. All patients were operated using the double-incision repair technique described by Morrey. The tendon was inserted with transosseous sutures into the biceps tuberosity. Patients were allowed to perform immediate postoperative active mobilization. A minimum follow-up of two years was required including clinical and radiological evaluation.

Results

Sixteen patients were lost to follow up leaving 58 (78%) patients for analysis with a mean follow-up of 53±19 months. At final follow-up, the mean evaluation for pain on the VAS scale was 0.22±0.7. Mean range of motion results included extension −1°±2°, flexion 138°±6°, pronation 72°±16° and supination 81°±10°. The strength ratio in flexion was 94±8% and in supination 90.5±12% compared to the contralateral limb. Subjective elbow value and DASH score were respectively 94±6% and 7.5±9%. All patients were satisfied or very satisfied and all except one returned to their previous sport. We noticed 2 heterotopic ossifications and one patient needed a reoperation for a radioulnar synostosis. Neither re-rupture nor nerve injury were observed.

Discussion

A double incision technique for distal biceps tendon repair is a minimally invasive procedure with reliable results. Morrey's modification of the initial procedure associated with early mobilization is associated with a low rate of complications and limited the occurrence of synostosis or ossifications.

Level of evidence

IV, case series, with no comparison group.

The full text of this article is available in PDF format.

Keywords : Distal biceps tear, Double incision technique, Early mobilisation, No nerve palsy




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