Late reconstruction of chronic distal biceps tendon ruptures with a semitendinosus autograft technique.

We compared 2 groups of patients with chronic distal biceps tendon ruptures, 7 patients treated nonoperatively and 7 undergoing semitendinosus autograft tendon reconstruction. The mean time to surgery after the initial injury was 17 weeks. The mean clinical follow-up in the operative group was 63 months. Functional strength and endurance testing was measured at a mean of 30 months after injury in the nonoperative group and 26 months in the operative group. A 2-incision technique was used. In the allograft reconstruction group, flexion and supination strength was restored to the normal range. The nonoperative group lacked 20% of normal strength. Endurance in both groups was within the normal range. Autograft semitendinosus reconstruction in chronic distal biceps tendon ruptures improves flexion and supination strength when compared with nonoperative treatment. No radial nerve injuries or heterotopic ossification occurred, and all reconstructions remain intact.