The Anatomy of the Bicipital Tuberosity in Distal Biceps Tendon

Author(s): Mazzocca AD, Cohen MS, Berkson E, et al.

Source: J Shoulder and Elbow  Surg  16:122-7, 2007

Summary:

In this cadaveric study, the authors evaluated 178 dried cadaveric radii, collecting data such as radial length, the length and width of the bicipital tuberosity, and the distance from the radial head to the bicipital tuberosity.  They evaluated the morphology of the icipital tuberosity ridge and defined it as smooth, small, medium, large, or bifid.  In addition, 48 specimens were analyzed with computerized tomography at the level of the bicipital tuberosity.  Finally, 18 fresh frozen cadavers were dissected to define the insertional footprint of the biceps tendon.

The authors demonstrate that the biceps tuberosity has a mean length of 22 +  3 mm and a mean width of 15 + 2 mm.  The authors noted that the footprint was a ribbon-shaped configuration on the most ulnar aspect of the biceps tuberosity, occupying 63% of the length and 13% of the width of the tuberosity proper. The authors found that the biceps tendon ridge was absent in 6% of specimens, bifid in 6% of specimens, and that the remaining 88% of the specimens had a single ridge that may be classified as small, medium or large.  The mean diameter of the radial head was found to be 22 mm + 3 mm, the mean radial neck shaft angle was 7 degrees +  3 degrees, and the mean biceps tuberosity radial styloid angle was 123 degrees +  10 degrees.  None of the measurements correlated with the patient’s age, sex or race.

The significance of this article lies in defining the anatomy of the proximal radius with respect to the head and the distal bicep insertion.  This has implications in techniques designed to repair the biceps following rupture.  For example, if a  single incision technique is be used, this study clearly documents that the footprint of the biceps tendon should be restored in its ribbon-like fashion rather than in a spot weld type fashion.  Finally, the authors report morphologic variance of biceps tendon insertions, which may be found to either contribute to or complicate treatment of distal biceps ruptures.


Elbow, Radial, Head, Biceps, Tendon, Insertion, Tuberosity, Anatomy


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