Distal biceps tendon rupture: biomechanics and fixation techniques

Rupture of the distal biceps tendon (DBT) is the most common elbow tendon rupture. As the primary supinator and secondary flexor of the forearm, rupture of the DBT results in significant functional deficits. DBT tears are more common in middle-aged men. Various surgical techniques for refixation of the DBT are currently used in daily clinical practice. The "single incision" technique using an isolated anterior approach has become an established procedure. The biomechanical evaluation of currently used implants and fixation methods shows promising in vitro results. When comparing the different implants, there is no clear biomechanical superiority of one implant or one technique, but the current techniques are approaching a primary stability that is comparable to native DBT. The current generation of suture anchors, all-suture anchors, also achieve a high failure loads and low displacement under cyclic loading. Consequently, favorable biomechanical conditions for healing of the DBT at the radial tuberosity are immediately postoperatively ensured. After DBT reattachment, good to excellent clinical results with restoration of flexion and supination strength were achieved. Serious complications following DBT reattachment are very rare. However, due to the close proximity of the surrounding neurovascular structures, there is a postoperative risk of injury to the lateral antebrachial cutaneous nerve and the posterior interosseous nerve (radial nerve). In our surgical procedure, unicortical onlay refixation with metal buttons and, in particular, the use of all-suture anchors have shown reliable and excellent results. In cases of chronic DBT ruptures, augmentation is performed with an autologous or allogeneic tendon graft. This article provides a comprehensive overview of the relevant biomechanical aspects and fixation techniques of the distal biceps tendon.     «

Rupture of the distal biceps tendon (DBT) is the most common elbow tendon rupture. As the primary supinator and secondary flexor of the forearm, rupture of the DBT results in significant functional deficits. DBT tears are more common in middle-aged men. Various surgical techniques for refixation of the DBT are currently used in daily clinical practice. The "single incision" technique using an isolated anterior approach has become an established procedure. The biomechanical evaluation of currentl...     »