Floor plan - 2013 Annual Meeting - American Association for Hand ...

Treatment of Distal Biceps Ruptures Using a One-Incision Technique and Biotenodesis Screw
Fixation: A Preliminary Report on Patient-Oriented Outcomes
Institution where the work was prepared: UMass Memorial Medical Center, Worcester, MA, USA
Mark Eskander, MD; Jonathan Eskander; Douglass Weiss; Nicola DeAngelis; UMass Medical School
OBJECTIVES:
Complete distal biceps brachii tendon ruptures are uncommon injuries. This type of injury can be approached by either a one or twoincision
method. Unfortunately, both have associated risks. Moreover, there are a variety of fixation techniques to choose from including
biotenodesis screws. The purpose of this study is to evaluate the patient outcomes of a one-incision technique coupled with biotenodesis
screws for treatment of distal biceps tendon ruptures.
METHODS:
We prospectively followed all patients who underwent surgery with this technique. Data from ten surgeries on nine patients coupled
with postoperative questionnaires (DASH and SF-12) were collected and analyzed. The surgeries took place from 2005-2006 by the
same surgeon. The cohort group consisted of employed males at an average age of 44 ranging from 31 to 56 years old. Eight out of
the nine patients were right-hand dominant, six were manual laborers, and four out of the ten ruptures were on the right side and the
other six were on the left. There were no intra-operative complications during the ten surgeries.
RESULTS:
The patients were all seen back at regular postoperative intervals and our DASH and SF-12 scores were collected at one year after surgery.
All patients demonstrated a normal range of motion (ROM) with flexion, extension, pronation, and supination except for one. The
postoperative mean flexion and supination strength were 5.0±0 and 4.9±0.21 respectively. The postoperative mean DASH, SF-12
Physical Component (PC), and SF-12 Mental Component (MC) scores were 9.91±13.88, 50.65±9.21, and 51.26±9.38 respectively. These
values are similar to the normative DASH (10.10±14.68) as well as SF-12 PC and MC (51.22±8.80, and 50.72±9.31) values for the US male
population. One patient in our group has additional medical problems affecting overall outcomes. If this patient is excluded, the DASH,
SF-12 PC, and MC are 7.68±12.68, 53.36±3.62, and 50.57±9.67 respectively. We noted an overall complication rate of 30% (three of the
ten surgeries). The complications included calcific tendonitis with decreased ROM after a partial re-rupture, decreased strength, and
numbness along the distribution of the radial sensory nerve.
CONCLUSION:
There is no consensus in the literature on the best way to treat distal biceps tendon ruptures. Our DASH and SF-12 scores imply the oneincision
approach and biotenodesis screw fixation provide excellent outcomes. Our complications are similar to those reported by other
authors and thus demonstrate the safety and effectiveness of this technique for patients who present with distal biceps tendon ruptures.
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