Distal Biceps Rupture Thomas J Kovack DO

Distal Biceps Rupture

Normal Anatomy Biceps muscle is responsible for flexing the forearm and supinating the forearm

Injury Rupture most common in active men between ages of 40 and 60 yrs old Also seen in younger men who are weighlifters Pre-existing degenerative changes may predispose tendon to rupture Usually single traumatic event involving flexion against resistance Patients often report painful tearing sensation in front of the elbow

Injury

Injury Patients present with bruising or swelling in the antecubital fossa Often is a defect where the tendon used to insert Patients note weakness in elbow flexion and forearm supination May have pain and cramping of the biceps muscle

Treatment Can be treated non-operatively Patient should expect 30% decrease in overall flexion strength and 40% decrease in supination strength (Morrey) Often can have contiuned cramping in the biceps muscle

Treatment Decision for surgery: Surgery allows anatomic re-attachment of tendon After surgery restoration of strength approaches normal in flexion and supination

Surgery Small single incision in front of arm Tendon is secured into the radius through sutures and anchors Same day surgery

Surgery

Surgery

Post-op After surgery you are in splint and sling for first week Weeks 1-4 are spent in Bledsoe brace

Post-op Weeks 4 -12 spent working on ROM as tolerated but no lifting At 3 months can begin biceps curls

Risks of Surgery Nerve Injury Arterial Injury Infection Loss of motion Heterotopic ossification Risks of anesthesia