This is a retrospective comparison of two groups of patients who underwent treatment for chronic distal biceps tendon ruptures. Seven patients were treated non-operatively and seven patients underwent semitendinosis tendon reconstruction. The patients presented at a mean of 17 weeks following the initial njury. The mean follow-up in the operative group was 63 months.
The authors compared functional strength and endurance testing at 30 months following the injury in the non-operative group verus 26 months in the operative group. The authors used a semitendinosis autograft from the biceps proximally to a drill hole through the radius using a two incision technique. Results indicated that in the autograft reconstruction, both flexion and supination strength was restored to normal range. The non-operative group exhibited a loss of 20% of normal strength in both flexion and supination. Endurance in both groups was within the normal range.
The obvious weakness in this study is the selection bias that exists; however, the results reinforce pre-existing studies, which indicate a loss of elbow flexion and supination strength following distal biceps ruptures. In addition, the results clearly indicate that the technique does restore flexion and supination strength. The authors acknowledge that return to heavy activity or employment was not permitted until at least nine months following the procedure. Despite this, all the operatively treated patients indicated that they would undergo the surgical procedure again.
Distal, Biceps, Tendon, Rupture, Chronic, Reconstruction, Autograft
J Shoulder and Elbow Surgery