This is a retrospective review of 13 patients with unilateral distal biceps tendon ruptures, followed-up at a minimum of 2 years. The repairs were performed via a 2 incision technique, and the patients were placed in hinged braces immediately post-operatively. Range of motion was limited to 60 degrees to full flexion on the first post-op day, and the extension block was decreased to 40 degrees at 2 weeks, 20 degrees at 4 weeks, and full extension at 6 weeks post-operatively.
There were no re-ruptures. The mean loss of motion was 6 degrees of full extension and no loss of flexion. Flexion strength was 91% of the uninjured side. Supination strength was 90% of the uninjured side. The mean DASH score was still 42. This study supports immediate motion following distal biceps tendon repair with gradual elbow extension. Most likely, the brachialis protects the biceps following repair making only forced flexion or supination against resistance contraindicated. Prolonged post-operative immobilization is most likely unnecessary in this clinical setting.
Journal of Shoulder and Elbow