Joideep Phadnis1, Olivia Flannery2, Adam C Watts2. 1. Upper Limb Unit, Wrightington Hospital, Wigan, UK; Brighton and Sussex University Hospitals, Brighton, UK. Electronic address: joideep@doctors.org.uk. 2. Upper Limb Unit, Wrightington Hospital, Wigan, UK.
Abstract
BACKGROUND: Distal biceps ruptures can result in ongoing pain and weakness when treated nonoperatively. If retraction of the tendon renders primary repair impossible, reconstruction using a graft is recommended. The current literature includes a variety of techniques with studies reporting small patient numbers. The aim of this study was to report the results of a larger cohort of patients using a technique modified from those previously described in the literature. METHODS: Twenty-one consecutive male patients underwent distal biceps reconstruction through 2 small anterior incisions using an Achilles tendon allograft that was fixed distally using a transosseous EndoButton and secured proximally using a Pulvertaft weave and tendon wrap. The mean age was 44 years, and the mean time to surgery was 25 months (range, 2-96 months). Functional outcomes were collected prospectively. RESULTS: The mean preoperative Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score (11 patients) was 1.9 (range, 0-4.5). The mean postoperative Oxford Elbow Score, QuickDASH score, and Mayo Elbow Performance Score were 44.7 (range, 35-48), 4 (range, 0-20.5), and 92.9 (range, 70-100), respectively, at a mean follow up of 15 months (range, 6-35 months). The mean postoperative QuickDASH score was significantly improved compared with preoperatively (P < .001). All patients were satisfied and all returned to their previous level of activity. There were 2 transient lateral antebrachial cutaneous nerve paresthesias, and 2 patients had a 5° extension lag. There were no other complications. CONCLUSION: Achilles allograft reconstruction of retracted irreparable distal biceps ruptures provides consistently good results with few complications using this technique. Crown
BACKGROUND: Distal biceps ruptures can result in ongoing pain and weakness when treated nonoperatively. If retraction of the tendon renders primary repair impossible, reconstruction using a graft is recommended. The current literature includes a variety of techniques with studies reporting small patient numbers. The aim of this study was to report the results of a larger cohort of patients using a technique modified from those previously described in the literature. METHODS: Twenty-one consecutive male patients underwent distal biceps reconstruction through 2 small anterior incisions using an Achilles tendon allograft that was fixed distally using a transosseous EndoButton and secured proximally using a Pulvertaft weave and tendon wrap. The mean age was 44 years, and the mean time to surgery was 25 months (range, 2-96 months). Functional outcomes were collected prospectively. RESULTS: The mean preoperative Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score (11 patients) was 1.9 (range, 0-4.5). The mean postoperative Oxford Elbow Score, QuickDASH score, and Mayo Elbow Performance Score were 44.7 (range, 35-48), 4 (range, 0-20.5), and 92.9 (range, 70-100), respectively, at a mean follow up of 15 months (range, 6-35 months). The mean postoperative QuickDASH score was significantly improved compared with preoperatively (P < .001). All patients were satisfied and all returned to their previous level of activity. There were 2 transient lateral antebrachial cutaneous nerve paresthesias, and 2 patients had a 5° extension lag. There were no other complications. CONCLUSION: Achilles allograft reconstruction of retracted irreparable distal biceps ruptures provides consistently good results with few complications using this technique. Crown
Authors: R J Molenaars; B J A Schoolmeesters; J Viveen; B The; D Eygendaal Journal: Knee Surg Sports Traumatol Arthrosc Date: 2018-10-19 Impact factor: 4.342
Authors: Toni Luokkala; Sijin K Sidharthan; Teemu V Karjalainen; Juha Paloneva; Adam C Watts Journal: Arch Orthop Trauma Surg Date: 2021-01-23 Impact factor: 3.067
Authors: Benjamin A Hendy; Eric M Padegimas; Thomas Harper; Mark D Lazarus; Joseph A Abboud; Surena Namdari; John G Horneff Journal: JSES Int Date: 2020-12-19
Authors: Jensen G Kolaczko; Derrick M Knapik; Christopher J McMellen; Sunita R Mengers; Robert J Gillespie; James E Voos Journal: Cureus Date: 2022-08-11