Distal biceps ruptures repair: Experience with 80 cases

• Published in: Revista española de cirugía ortopédica y traumatología 2021-09, Vol.65 (5), p.363-373
• Main Authors: Jiménez-Martín, A., Santos-Yubero, F.J., Najarro-Cid, F.J., Navarro-Martínez, S.
• Format: Article
• Language: English
• Subjects: Biceps; Bíceps; Rotura; Rupture; Tendon; Tendón
• ISSN: 1988-8856; 1988-8856
• DOI: 10.1016/j.recote.2021.05.003

Rupture of distal biceps has a frequency of 1.2 cases per 100,000 population. Conservative treatment presents a loss in supination of 40% and flexion of 30%, like transfers to the brachialis. Our goal is to review our experience with anatomical reattachment. Cohorts study. We analized an historic cohort, although recent, treated with double approach (Boyd-Anderson) compared to another prospective cohort (treated with single and double approach). Sample size of 80 patients. Mean age of 48.9 ± 5.9 years. We analyzed laterality, time to diagnosis, presurgery time, surgery time, approach, type of reintegration, rehabilitation time, Mayo Elbow Performance Score (MEPS), biomechanical study and complications. Follow up from 2 years to 7 years. Time for diagnosis was about 4 days. Preoperative time: 12.2 ± 6.4 days. Surgical time: 61.9 ± 15.7 min. We used the two-way surgical approach (Boyd-Anderson-Morrey) in 78.8% of patients, and the anterior surgical approach (Henry) in 21.2% of cases. Transosseous reinsertion was made in 45% of cases, with screw anchor in 40% and with cortical button in 15%. Rehabilitation time: 91 ± 29.7 days. MEPS: 88 ± 11.7 points. There was loss of flexor strength of 28 ± 16.6%. Complications: 1 case of proximal radioulnar synostosis, 2 radial transient paralysis and 5 cases with residual stiffness. Hypothesis contrast: We reached best results in MEPS with double surgical approach (P = .009), with fewer complications (P = .008). We observed increased pain with cortical buttons (P