Distal Biceps Tendon Rupture / Avulsion
The biceps muscle has tendons at the top going into the shoulder, and the distal biceps tendon going down the arm which inserts into an area of the radial bone in the forearm. It is possible for the distal biceps tendon to pull off the radius bone. It usually occurs with forced use of the biceps and muscle in middle-aged or older males. If it happens you usually feel something pop or rip in your elbow with pain, and bruising and stiffness occur in the following days. The biceps muscle often changes shape. Over the longer long term, this injury typically results in the loss of 20% of the strength of elbow bending (flexion), and 35% loss of strength of one direction of forearm rotation (supination), and a significant reduction in stamina in the elbow use. As a result, it is usually advisable to surgically repair this tendon to the radial bone ideally as soon as practicable after injury.
Distal Biceps Tendon Rupture Treatment
The surgery involves a general anaesthetic and one wound in the forearm. Occasionally a wound in the arm above the elbow will also be necessary to retrieve the end of the tendon which has migrated up into the arm. An endoscope (telescope) is used to assist in making the incision(s) as small as possible. The tendon is reattached onto or into the bone using stitches with or without a bone anchor(s). Most often this can be undertaken as a day case. An arm splint may sometimes be necessary for six weeks post surgery, but in most cases, a sling is all that is required to be worn for comfort.
Distal Biceps Tendon Repair Postoperative Care
Very light arm use is allowed for six weeks (light daily activities but no substantial use of your arm to allow the tendon to heal and prevent it pulling out of the radius bone), and no heavy activities until twelve weeks after surgery. Your bandages can be removed two days postoperatively. If you are seeing the hand therapists, they may remove the bandage the day after surgery. Sutures will be internal, and 10 days after surgery you can remove your dressing and wash the skin as normal.