Distal Biceps Rupture Thomas J Kovack DO Distal

Distal Biceps Rupture Thomas J Kovack DO

Distal Biceps Rupture

Normal Anatomy n 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 n Also seen in younger men who are weighlifters n Pre-existing degenerative changes may predispose tendon to rupture n Usually single traumatic event involving flexion against resistance n Patients often report painful tearing sensation in front of the elbow n

Injury

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

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

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

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

Surgery

Surgery

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

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

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