Primary repair of severely retracted nonchronic distal biceps tendon rupture using 2-incision anterior-approach repair
Background: Primary repair of a severely retracted distal biceps tendon can pose a technical challenge. We sought to describe the method and clinical outcomes of a surgical technique used as an adjunct to the conventional anterior single-incision repair for severely retracted biceps tendons. This te...
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doaj-6d45cdc010734c248e5a25b620bf04182021-03-22T08:44:48ZengElsevierJSES International2666-63832020-06-0142231237Primary repair of severely retracted nonchronic distal biceps tendon rupture using 2-incision anterior-approach repairNoah DeAngelo, BS0Rachel A. Thomas, BS1H. Mike Kim, MD2Department of Orthopaedics and Rehabilitation, Penn State College of Medicine Milton S. Hershey Medical Center, Hershey, PA, USADepartment of Orthopaedics and Rehabilitation, Penn State College of Medicine Milton S. Hershey Medical Center, Hershey, PA, USADepartment of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA; Corresponding author: H. Mike Kim, MD, Department of Surgery, University of Missouri, 1100 Virginia Ave, Columbia, MO 65212, USA.Background: Primary repair of a severely retracted distal biceps tendon can pose a technical challenge. We sought to describe the method and clinical outcomes of a surgical technique used as an adjunct to the conventional anterior single-incision repair for severely retracted biceps tendons. This technique involves a second anterior incision proximally to retrieve a severely retracted tendon followed by passing the tendon through a soft-tissue tunnel. Methods: We identified 30 consecutive patients who had undergone a primary distal biceps tendon repair by an anterior-approach cortical-button technique. A phone survey was conducted for patient-reported outcomes. Patients returned for bilateral forearm supination strength testing in 2 positions (45º of pronation and 45º of supination). Outcomes were compared between patients who required a second incision and high elbow flexion (>60º) because of severe tendon retraction and those who did not require such interventions. Results: No significant differences in elbow range of motion, supination strength, or patient-reported outcomes were found between the 2 groups of patients (P > .05). Regarding supination strength, the operated side was significantly weaker than the uninjured side in both pronated and supinated positions (P < .05). Both the operated and uninjured sides showed significantly higher torque in a pronated position than in a supinated position (P < .05). Conclusions: Severely retracted distal biceps tendons can be successfully repaired using a second incision and high elbow flexion without negative effects on the outcomes. Supination strength was decreased following an anterior-approach cortical-button technique, but patient-reported outcomes were not affected negatively.http://www.sciencedirect.com/science/article/pii/S266663832030013XDistal biceps tendoncortical buttonanterior approach2-incision techniquesupination strengthpatient-reported outcome |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Noah DeAngelo, BS Rachel A. Thomas, BS H. Mike Kim, MD |
spellingShingle |
Noah DeAngelo, BS Rachel A. Thomas, BS H. Mike Kim, MD Primary repair of severely retracted nonchronic distal biceps tendon rupture using 2-incision anterior-approach repair JSES International Distal biceps tendon cortical button anterior approach 2-incision technique supination strength patient-reported outcome |
author_facet |
Noah DeAngelo, BS Rachel A. Thomas, BS H. Mike Kim, MD |
author_sort |
Noah DeAngelo, BS |
title |
Primary repair of severely retracted nonchronic distal biceps tendon rupture using 2-incision anterior-approach repair |
title_short |
Primary repair of severely retracted nonchronic distal biceps tendon rupture using 2-incision anterior-approach repair |
title_full |
Primary repair of severely retracted nonchronic distal biceps tendon rupture using 2-incision anterior-approach repair |
title_fullStr |
Primary repair of severely retracted nonchronic distal biceps tendon rupture using 2-incision anterior-approach repair |
title_full_unstemmed |
Primary repair of severely retracted nonchronic distal biceps tendon rupture using 2-incision anterior-approach repair |
title_sort |
primary repair of severely retracted nonchronic distal biceps tendon rupture using 2-incision anterior-approach repair |
publisher |
Elsevier |
series |
JSES International |
issn |
2666-6383 |
publishDate |
2020-06-01 |
description |
Background: Primary repair of a severely retracted distal biceps tendon can pose a technical challenge. We sought to describe the method and clinical outcomes of a surgical technique used as an adjunct to the conventional anterior single-incision repair for severely retracted biceps tendons. This technique involves a second anterior incision proximally to retrieve a severely retracted tendon followed by passing the tendon through a soft-tissue tunnel. Methods: We identified 30 consecutive patients who had undergone a primary distal biceps tendon repair by an anterior-approach cortical-button technique. A phone survey was conducted for patient-reported outcomes. Patients returned for bilateral forearm supination strength testing in 2 positions (45º of pronation and 45º of supination). Outcomes were compared between patients who required a second incision and high elbow flexion (>60º) because of severe tendon retraction and those who did not require such interventions. Results: No significant differences in elbow range of motion, supination strength, or patient-reported outcomes were found between the 2 groups of patients (P > .05). Regarding supination strength, the operated side was significantly weaker than the uninjured side in both pronated and supinated positions (P < .05). Both the operated and uninjured sides showed significantly higher torque in a pronated position than in a supinated position (P < .05). Conclusions: Severely retracted distal biceps tendons can be successfully repaired using a second incision and high elbow flexion without negative effects on the outcomes. Supination strength was decreased following an anterior-approach cortical-button technique, but patient-reported outcomes were not affected negatively. |
topic |
Distal biceps tendon cortical button anterior approach 2-incision technique supination strength patient-reported outcome |
url |
http://www.sciencedirect.com/science/article/pii/S266663832030013X |
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