Repair of Distal Biceps Ruptures

Baratz M, King GJW, Steinmann S (Drexel Univ, Pittsburgh, PA; Univ of Western Ontario, London, Ontario, Canada; Mayo Clinic, Rochester, MN) J Hand Surg 37A:1462-1466, 2012^§

Abstract

Background

Distal biceps ruptures can cause permanent loss of 30% to 50% of supination strength if left unrepaired. However, the best treatment, surgical approach, timing of repair, fixation method, and postoperative management regimen for these injuries remain undetermined. The evidence currently available was reviewed.

Treatment Options

Untreated rupture of the distal biceps can cause varying degrees of loss of supination strength and flexion strength. However, endurance and the eventual functional outcome appear not to be affected by nonsurgical treatment.

Surgical approaches include a single-incision anterior option and a two-incision, combined anteroposterior approach. Some laboratory data indicate the two-incision approach offers advantages over the single-incision approach, but these differences may not be meaningful to the patient. Generally it is recommended that repair be done within 2 weeks of injury to avoid perhaps doubling the incidence of complications. However, direct repair has been performed more than 31 days after injury with a return of supination strength ranging from 47% to 103% of preinjury levels.

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