Pieter Caekebeke1, Kira Vande Voorde2, Joris Duerinckx2, Roger van Riet3. 1. Ziekenhuis Oost-Limburg, Department of Orthopaedic Surgery and Traumatology, Schiepse Bos 6, 3600 Genk, Belgium. Electronic address: caekebeke.pieter@hotmail.com. 2. Ziekenhuis Oost-Limburg, Department of Orthopaedic Surgery and Traumatology, Schiepse Bos 6, 3600 Genk, Belgium. 3. AZ Monica, Department of Orthopedic Surgery, Stevenslei 20, 2100 Deurne, Antwerp, Belgium; University Hospital Antwerp, Department of Orthopaedic Surgery, Wilrijkstraat 10, 2650 Edegem, Belgium.
Abstract
BACKGROUND: Intramedullar fixation in distal biceps tendon repair may be a solution to address specific shortcomings of current fixation techniques. Most investigations are limited to biomechanical evaluation. The purpose of the present study was to report the short-term outcomes of an intramedullar fixation device. METHODS: We evaluated functional and radiographic outcomes up to six months of follow-up. Patients with an acute distal biceps tendon rupture eligible for surgical repair were invited to take part in the study. Ten patients were included in the final analysis. All patients were evaluated both clinically and radiographically at 2 weeks, 6 weeks, 3 months and 6 months. Outcomes were recorded using the visual analog scale score for pain, the Mayo Elbow Performance Score, and Disabilities of the Arm, Shoulder, and Hand scores. Radiographic evaluation comprised X-ray and CT evaluation. RESULTS: There were no failures of fixation in the patient group examined. Elbow mobility was symmetric for all patients from 3 months onwards. Supination strength was 86% of the uninjured side at final follow-up. Mean Disabilities of the Arm, Shoulder, and Hand score and Mayo Elbow Performance Score at final follow-up were 0 and 100, respectively. Computed tomography images showed no signs of button migration, cortical thinning due to button pressure or button breakout. The tendon could be followed to the button in all cases. CONCLUSIONS: The intramedullary fixation button technique to repair the distal biceps tendon has excellent functional outcomes at six months. No adverse reactions of the button on the bone were seen. As this technique minimizes the risk of PIN injury and has sufficient bone tunnel to avoid gap formation this may be a promising new technique for distal biceps tendon ruptures refixation.
BACKGROUND: Intramedullar fixation in distal biceps tendon repair may be a solution to address specific shortcomings of current fixation techniques. Most investigations are limited to biomechanical evaluation. The purpose of the present study was to report the short-term outcomes of an intramedullar fixation device. METHODS: We evaluated functional and radiographic outcomes up to six months of follow-up. Patients with an acute distal biceps tendon rupture eligible for surgical repair were invited to take part in the study. Ten patients were included in the final analysis. All patients were evaluated both clinically and radiographically at 2 weeks, 6 weeks, 3 months and 6 months. Outcomes were recorded using the visual analog scale score for pain, the Mayo Elbow Performance Score, and Disabilities of the Arm, Shoulder, and Hand scores. Radiographic evaluation comprised X-ray and CT evaluation. RESULTS: There were no failures of fixation in the patient group examined. Elbow mobility was symmetric for all patients from 3 months onwards. Supination strength was 86% of the uninjured side at final follow-up. Mean Disabilities of the Arm, Shoulder, and Hand score and Mayo Elbow Performance Score at final follow-up were 0 and 100, respectively. Computed tomography images showed no signs of button migration, cortical thinning due to button pressure or button breakout. The tendon could be followed to the button in all cases. CONCLUSIONS: The intramedullary fixation button technique to repair the distal biceps tendon has excellent functional outcomes at six months. No adverse reactions of the button on the bone were seen. As this technique minimizes the risk of PIN injury and has sufficient bone tunnel to avoid gap formation this may be a promising new technique for distal biceps tendon ruptures refixation.