Distal biceps hook test - Sensitivity in acute and chronic tears and ability to predict the need for graft reconstruction.

Abstract

The aim of this study was to assess the sensitivity of distal biceps hook test - O'Driscoll hook test - in a retrospective series of acute and chronic distal biceps tendon tears and investigate the ability of the test to predict the need for graft reconstruction. We retrospectively evaluated 234 consecutive distal biceps tendon tears operated in a single centre. The result of O'Driscoll hook test and perioperative findings of distal biceps were documented in standard fashion. The perioperative and O'Driscoll hook test data were available in 202 cases. The sensitivity for the distal biceps hook test was 78% in all tears and 83% in complete tears. The sensitivity was significantly lower in partial tears (30%) and in cases where lacertus fibrosus was found to be intact (45 %). When O'Driscoll hook test was positive and the delay from initial injury to operative intervention was eight weeks or more, there was over 75% probability of achilles tendon allograft reconstruction. When O'Driscoll hook test was negative, the probability of reconstruction even after 12 weeks' delay was only 20%. O'Driscoll hook test is useful when establishing distal biceps tendon tear diagnosis, but a negative test does not exclude rupture. In delayed cases, a positive test may predict the need for reconstruction.