Inderpaul Samra1, Wael Mati2, Clare Blundell1, Suzanne Lane1, Charalambos P Charalambous3,1. 1. Department of Trauma and Orthopaedic Surgery, Blackpool Victoria Hospital, Blackpool, United Kingdom. 2. Department of Radiology, Blackpool Victoria Hospital, Blackpool, United Kingdom. 3. School of Medicine, University of Central Lancashire, United Kingdom.
Abstract
AIMS: To assess whether the degree of radiological retraction and chronicity of distal biceps tendon ruptures are related to the ability to reattach the tendon and long-term functional outcomes. METHODS: Analysis of consecutive patients undergoing surgery for distal biceps tendon ruptures by a single surgeon. Measurements regarding the site and degree of tendon retraction in relation to anatomical landmarks following rupture were correlated with intraoperative findings. Postoperative functional outcomes were assessed in cases with >12 months follow-up. RESULTS: 24 cases of distal biceps tendon ruptures treated surgically were identified. Mean tendon retraction was 6.0 cm (range 1.2-9.5) from the radial tuberosity. 22 cases were reattached successfully. 2 required ligament augmentation/bridging using a synthetic ligament. In 2 cases the tendon could not be reattached due to poor quality of the tendon stump. Ability to reattach the tendon was unrelated to degree of radiological retraction or chronicity of rupture. Degree of retraction was not related to rupture chronicity. All reattachments healed with no re-rupture at follow-up with no substantial motion loss. In 17 cases >12months follow-up the DASH and OES were not related to retraction or chronicity of rupture. CONCLUSIONS: Radiological retraction and chronicity are not related to the ability to reattach distal biceps tendon ruptures or their clinical outcomes, hence should not discourage surgical exploration and attempted reattachment. Substantial tendon retractions can occur acutely and reattachment in considerable flexion did not produce any significant motion loss. Some cases will need augmentation or gap bridging and augmentation devices need to be available at surgery. LEVEL OF EVIDENCE: Level IV Retrospective Study Defined.
AIMS: To assess whether the degree of radiological retraction and chronicity of distal biceps tendon ruptures are related to the ability to reattach the tendon and long-term functional outcomes. METHODS: Analysis of consecutive patients undergoing surgery for distal biceps tendon ruptures by a single surgeon. Measurements regarding the site and degree of tendon retraction in relation to anatomical landmarks following rupture were correlated with intraoperative findings. Postoperative functional outcomes were assessed in cases with >12 months follow-up. RESULTS: 24 cases of distal biceps tendon ruptures treated surgically were identified. Mean tendon retraction was 6.0 cm (range 1.2-9.5) from the radial tuberosity. 22 cases were reattached successfully. 2 required ligament augmentation/bridging using a synthetic ligament. In 2 cases the tendon could not be reattached due to poor quality of the tendon stump. Ability to reattach the tendon was unrelated to degree of radiological retraction or chronicity of rupture. Degree of retraction was not related to rupture chronicity. All reattachments healed with no re-rupture at follow-up with no substantial motion loss. In 17 cases >12months follow-up the DASH and OES were not related to retraction or chronicity of rupture. CONCLUSIONS: Radiological retraction and chronicity are not related to the ability to reattach distal biceps tendon ruptures or their clinical outcomes, hence should not discourage surgical exploration and attempted reattachment. Substantial tendon retractions can occur acutely and reattachment in considerable flexion did not produce any significant motion loss. Some cases will need augmentation or gap bridging and augmentation devices need to be available at surgery. LEVEL OF EVIDENCE: Level IV Retrospective Study Defined.
Authors: Carrie A Lindsey; Marina R Makarov; Scott Shoemaker; John G Birch; Peter H Buschang; Alexander M Cherkashin; Robert D Welch; Mikhail L Samchukov Journal: Clin Orthop Relat Res Date: 2002-09 Impact factor: 4.176
Authors: Taylor R Dunphy; Justin Hudson; Michael Batech; Daniel C Acevedo; Raffy Mirzayan Journal: Am J Sports Med Date: 2017-08-24 Impact factor: 6.202