Single incision technique for distal biceps tendon repair: using the endobutton

2003 ◽  
Vol 11 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Jeff A Fox ◽  
John J. Fernandez
Keyword(s):  
Single Incision ◽  
Biceps Tendon ◽  
Tendon Repair ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Biceps Tendon Repair ◽  
Incision Technique

scholarly journals Distal Biceps Tendon Repair Using A Single-incision Approach With Unicortical Intramedullary Button Fixation: Report Early Post-operative Outcomes And Complications

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0036
Author(s):  
Kenneth M. Lin ◽  
Justin Chan ◽  
Brian J. Lin ◽  
Christopher L. Camp ◽  
Grant Hoerig Garcia ◽  
...  
Keyword(s):  
Heterotopic Ossification ◽  
Single Incision ◽  
Biceps Tendon ◽  
Tendon Repair ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Distal Biceps Repair ◽  
Cortical Button ◽  
Biceps Tendon Repair

Objectives: While various techniques for distal biceps repair have been described, biomechanical studies have shown cortical button fixation to outperform bone tunnels, intraosseous screws, and suture anchors. Furthermore, numerous studies have shown no difference in complication rate between single- and dual-incision approaches. Thus, it follows that a single-incision approach with cortical button fixation may provide superior clinical outcomes with minimal complications. The purpose of this study is first to investigate intra-operative and short-term complications of distal biceps tendon repair through a single-incision approach using unicortical button fixation, and secondly to assess clinical outcomes. Methods: 52 patients who underwent distal biceps repair with unicortical button fixation (Figure 1) at a single institution from 2014 to 2017 were identified. Exclusion criteria included age less than 18 or greater than 75 years, prior ipsilateral biceps repair, concomitant ipsilateral surgical procedure, and most recent follow-up less than 2 months. Postoperative nerve deficits, flexion and supination strength by manual testing, range of motion, Mayo Elbow Performance Score (MEPS) and radiographs for identification of heterotopic ossification (HO) were obtained and analyzed retrospectively. Results: Fifty-two patients with 53 distal biceps ruptures were included, with mean age 48 years (range 25-71 years). Median time from injury to surgery was 2 weeks (range 1 day to 16 weeks), with 15 patients being treated at greater than 3 weeks from injury. Forty-four patients (83%) had complete tears. Following surgery, average time to final follow-up was 22.8 weeks (range 8-65 weeks). Postoperatively, 49 patients (92.5%) had full range of motion, 48 patients (90.6%) had return of full supination and flexion strength by manual muscle testing (the remaining patients had strength graded as 5-/5). There was no difference in outcomes between those patients treated < 3 weeks from injury compared to those treated > 3 weeks from injury. Two patients (3.8%) initially reported sensory deficit in the lateral antebrachial cutaneous nerve distribution, both cases of which fully resolved by 7 and 11 weeks postoperative. Two patients (3.8%) displayed radiographic evidence of heterotopic ossification, Hastings and Graham class I (Figure 2). One of these was an incidental finding without any clinical symptoms, the other had mild pain but normal strength and neurovascular function. Mean postoperative MEPS was 93.9 (range 60-100), corresponding to “excellent” function (MEPS>90). Conclusion: Distal biceps repair using single incision, unicortical button fixation yields a low rate of complications with good clinical results compared to other techniques reported in the literature. The single incision approach in patients treated between 3 and 16 weeks from injury is safe and resulted in outcomes no different than in those patients treated <3 weeks from injury. Further investigation is warranted in the form of larger, comparative studies with more robust outcome measures and longer term follow up. [Figure: see text][Figure: see text]

scholarly journals Minimal Damage to the Supinator Muscle After the Double-Incision Technique for Distal Biceps Tendon Repair

2020 ◽  
Vol 8 (12) ◽  
pp. 232596712096777
Author(s):  
Davide Blonna ◽  
Alberto Olivero ◽  
Claudia Galletta ◽  
Valentina Greco ◽  
Filippo Castoldi ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Tendon Repair ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Supinator Muscle ◽  
Fat Fraction ◽  
Biceps Tendon Repair ◽  
Incision Technique ◽  
Bicipital Tuberosity

Background: The effect of the double-incision technique on the supinator muscle is unclear. Purpose: The aim of this study was to quantify fatty atrophy of the supinator muscle and map the area of muscle damage. Study Design: Case series; Level of evidence, 4. Methods: A total of 19 male patients (median age, 43 years) who underwent distal biceps tendon repair were included in the analysis. Patients with a minimum of 12 months of follow-up were included. The following variables were analyzed: range of motion; shortened version of Disabilities of the Arm, Shoulder and Hand (QuickDASH) score; Summary Outcome Determination (SOD) score; and isokinetic peak force and endurance in supination. Quantitative analysis and mapping of fatty infiltration of the supinator muscle were based on the calculation of proton density fat fraction on magnetic resonance imaging scans of both elbows using the IDEAL (Iterative Decomposition of Echoes of Asymmetrical Length) sequence. Results: At an average follow-up of 24 months (range, 12-64 months), the median SOD score was 9.0 (95% CI, 7.8-9.4), and the mean QuickDASH score was 6.7 (95% CI, 0.0-14.1). A difference of 17% in peak torque was measured between repaired and nonrepaired elbows (repaired elbow: 9.7 N·m; nonrepaired elbow: 11.7 N·m; P = .11). Endurance was better in the repaired elbow than the nonrepaired elbow (8.4% vs 14.9% work fatigue, respectively; P = .02). The average fat fraction of the supinator muscle was 19% (95% CI, 16%-21%) in repaired elbows and 14% (95% CI, 13%-16%) in contralateral elbows ( P = .04). The increase in fat fraction was located in a limited area between the radius and ulna at the level of the bicipital tuberosity. Conclusion: The assessment of the supinator muscle showed a limited increase in fat fraction between the radius and ulna at the level of the bicipital tuberosity. No significant effect on supination strength was highlighted.

MODIFIED SINGLE-INCISION DISTAL BICEPS TENDON REPAIR USING THREE SUTURE ANCHORS: SURGICAL TECHNIQUE

Hand Surgery ◽  
2012 ◽  
Vol 17 (03) ◽  
pp. 409-412 ◽  
Author(s):  
Du Hyun Ro ◽  
Goo Hyun Baek ◽  
Hyun Sik Gong
Keyword(s):  
Single Incision ◽  
Biceps Tendon ◽  
Tendon Repair ◽  
Suture Anchors ◽  
Confined Space ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Surgical Methods ◽  
Biceps Tendon Rupture ◽  
Biceps Tendon Repair

Complete distal biceps tendon rupture causes a considerable loss of supination and flexion strength, and thus, surgical repair is indicated in active individuals. To reduce the risk of injury to the radial nerve in the confined space where the distal biceps inserts into the radius, several surgical methods have been reported, such as, pull out sutures, two-incision techniques, and the use of suture anchors. Here, we describe our modified single-incision distal biceps tendon repair technique using three suture anchors, which widens the bone-tendon contact surface and simplifies tensioning of the tendon attachment.

scholarly journals Distal Biceps Tendon Repair Using a Modified Double-Incision Technique: Patient-Reported Outcomes With 10-Year Follow-up

2020 ◽  
Vol 8 (8) ◽  
pp. 232596712094481
Author(s):  
Sam Razaeian ◽  
Dafang Zhang ◽  
Afif Harb ◽  
Rupert Meller ◽  
Christian Krettek ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Tendon Repair ◽  
Social Psychological ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Patient Reported ◽  
Biceps Tendon Repair ◽  
Incision Technique

Background: In the setting of complete distal biceps tendon rupture, surgical repair has become the standard of care to restore optimal elbow function, but the optimal approach and method of tendon fixation are still subjects of debate and have remained controversial for more than half a century. Purpose: To evaluate patient-reported long-term outcomes after distal biceps tendon repair using a modified double-incision technique. Study Design: Case series; Level of evidence, 4. Methods: We reviewed primary distal biceps tendon repairs after isolated tendon rupture using the modified muscle-splitting double-incision approach and transosseous suture fixation technique described by Morrey et al (1985), which had been performed at our level 1 trauma center between January 2000 and December 2013. Outcome measures included the subjective elbow value (SEV), the Oxford Elbow Score (OES) with its 3 domains (function, pain, and social-psychological), a self-performed hook test, and the 3-level version of the EuroQoL 5-dimensional instrument (EQ-5D-3L) as a measure of health status. Levels of overall satisfaction were determined by asking whether the patient would consent to the operation again. In addition, patients were asked to report any complications. Results: A total of 30 patients met the inclusion criteria, and 25 patients were available for the survey. Mean age at the time of rupture was 47 years. All patients were male. Mean follow-up was 120 months (range, 57-207 months). The follow-up rate was 83.34%. The following outcome results were obtained: SEV, 88.16% ± 25.18%; OES, 43.80 ± 10.56 out of 48 points; OES Pain, 92.50% ± 23.03%; OES Function, 92.25% ± 22.19%; OES Social-Psychological, 89% ± 23.68%; EQ-5D-3L, 0.93 ± 0.21. All patients described a negative hook test. Patient-reported complications included painless limitation in forearm rotation in 8% of patients (n = 2); reduced flexion and forearm rotation strength with and without pain in 8% (n = 2) and 4% (n = 1), respectively; synostosis after 1 year requiring revision surgery in 4% (n = 1); and transient wrist drop in 4% (n = 1). The overall complication rate was 28% (7/25), and 96% (n = 24) would consent to the operation again. Conclusion: Despite the cited approach-related morbidity, we report an excellent patient-reported long-term outcome for the double-incision distal biceps repair technique.

A functional analysis of distal biceps tendon repair: single-incision Endobutton technique vs. two-incision modified Boyd–Anderson technique

2015 ◽  
Vol 44 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Steven B. Cohen ◽  
Patrick S. Buckley ◽  
Brian Neuman ◽  
J. Martin Leland ◽  
Michael G. Ciccotti ◽  
...  
Keyword(s):  
Functional Analysis ◽  
Single Incision ◽  
Biceps Tendon ◽  
Tendon Repair ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Biceps Tendon Repair

scholarly journals One- Versus Two-Incision Technique for Distal Biceps Tendon Repair

2008 ◽  
Vol 4 (2) ◽  
pp. 117-122 ◽  
Author(s):  
Timothy S. Johnson ◽  
David C. Johnson ◽  
Michael K. Shindle ◽  
Answorth A. Allen ◽  
Andrew J. Weiland ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Tendon Repair ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Biceps Tendon Repair ◽  
Incision Technique
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