- One Incision - Modified Henry Approach:
- see:
Henry Approach to the Forearm;
- some surgeons feel that this is the prefered technique noting that modern suture anchors anchors have permitted safe repair of the biceps tendon
through one anterior incision;
- advantages: direct approach, avoids PIN injury, and minimal ectopic bone formation;
- disadvantages: may injury radial nerve if surgeon attempts to pass tendon thru drill holes made in the radius;
- this is less of a problem now that stronger bone anchors are available;
-
incision:
- begins either medial or lateral to biceps, extends transversely over the antecubital fossa,
and then extends distally over the BR;
- identify and protect the
lateral antibrachial cutaneous nerve;
- tendon end is identified, elevated out of wound, and debrided;
- thru the empty space (occupied by the biceps), insert a tonsil and identify the radial tuberosity (forearm fully supinated);
- insert bone anchors into the tuberosity, and reattach the tendon;
- ref:
The Effect of Drilling Angle on PIN Safety During Open and Endoscopic Anterior Single-Incision Repair of the Distal Biceps Tendon
-
postoperative care:
- immobilize the elbow in 90 deg flexion for 2 weeks followed by progressive increases in elbow ROM using hinged brace;
- passive pronation and supination with the elbow flexed at or greater than 90° of flexion is allowed after 2 weeks;
- active flexion is started at 8 weeks;
Rupture of the distal insertion of the biceps brachi tendon.
Rupture of the distal tendon of the biceps brachi. A biomechanical study.
Rupture of the distal tendon of the biceps brachi, Operative versus non-operative treatment.
Distal biceps brachii tendon avulsion: a simplified method of operative repair. DS Louis et al. Am J. Sports Med. Vol 14. 1986. p 234.
Partial rupture of the distal biceps tendon.
Repair of the distal biceps tendon using suture anchors and an anterior
Single-incision repair of acute distal biceps ruptures by use of suture anchors.
Distal biceps brachii repair. Results in dominant and nondominant extremities.
A method for reinsertion of the distal biceps brachii tendon. HB Boyd et al. JBJS. 43-A. 1961. p 1041.
Rupture of the distal biceps tendon: biomechanical assessment of different treatment options. WH Norman. CORR. Vol 193. 1985. p 189.
Clinical, Functional, and Xray Assessments of the Conventional and Boyd-Anderson Surgical Procedures for Repair of Distal Biceps Tendon Ruptures.
Patrick D'Arco MEd, ATC. American Journal of Sports Medicine Vol 26 No 2 March - April 1998
Complications of Repair of the Distal Biceps Tendon with the Modified Two-Incision Technique. EW. Kelly MD JBJS [Am] 82-A: 1575-81, 2000
Repair of distal biceps tendon ruptures using a suture anchor and an anterior approach.
The Effect of Drilling Angle on PIN Safety During Open and Endoscopic Anterior Single-Incision Repair of the Distal Biceps Tendon
Complications of distal biceps tendon repairs.
......................................................... ........................................... ........................................................... ........................................
