Surgical Technique for Single and Double-Incision Method of Acute Distal Biceps Tendon Repair.

Abstract

Distal biceps tendon ruptures can be repaired with either a single or a double-incision technique. Through a single anterior incision, identify the tendon and debride the distal degenerated portion. Expose the bicipital tuberosity and prepare the bone for insertion of suture anchors. Suture the tendon with a reduction knot technique that allows for anatomic tendon apposition to bone. Through a small anterior incision retrieve the tendon, debride the distal degenerated portion of the tendon, and place your sutures. Through a second posterolateral incision, expose the biceps tuberosity and, using a burr, create a trough for the tendon. Pass the sutures through the transosseous tunnels and tension the sutures, allowing the biceps tendon to be pulled into the trough created in the bicipital tuberosity, and then tie the sutures. Assess tension across the repaired tendon, initiate prophylaxis against heterotopic ossification, and begin rehabilitation. We recently conducted a prospective randomized controlled trial at our center comparing the single and double-incision techniques for the repair of acute distal biceps tendon ruptures¹¹. IndicationsContraindicationsPitfalls & Challenges.