Elsevier

Journal of Hand Surgery Global Online

Surgical Technique

Distal Biceps Repair Using a Unicortical Intramedullary Button Technique: A Case Series

Under a Creative Eatables license

Open access

Purpose

Although surgical repair of distal biceps tendon rupture improves functional outcomes compared with nonsurgical treatments, the option of operative technique remains a matter of preference. This written report retrospectively examined outcomes from a repair technique using a volar distal biceps reinsertion secured with a unicortical intramedullary button in the proximal radial tuberosity to determine its safe and functional outcomes.

Methods

A single fellowship-trained shoulder and elbow surgeon treated 27 men, average historic period 48 years (range, 25–66 years), between 2012 and 2016. Patient-reported outcomes included the Disabilities of the Arm, Shoulder, and Hand and American Shoulder and Elbow Surgeons (ASES) satisfaction scores and the Mayo Elbow Performance Score. Average patient follow-up was 24 months.

Results

This series had an overall complication rate of 39.3% (11 of 28): 9 lateral antebrachial cutaneous neuropraxias, ane radial sensory nerve irritation, and one superficial infection. No complications of peripheral nerve injury, proximal radioulnar synostosis, or rerupture were observed. Results (mean ± SD) demonstrated low disability (Disabilities of the Arm, Shoulder, and Manus score = ii.ix ± 5.3), high satisfaction (American Shoulder and Elbow Surgeons score = 9.3 ± one.iv), and adequate functioning (Mayo Elbow Performance Score = 97.seven ± 6.3). Subcategory analysis identified a correlation between time to surgery and complications. Disability scores were higher in patients with workers' compensation claims versus private insurance (mean, 11.0 vs 1.ane).

Conclusions

Further trials are required to compare the results and complexity rates of this unicortical intramedullary button procedure with other established methods.

Blazon of study/level of evidence

Therapeutic 4.

Primal words

distal biceps repair

single incision

unicortical button

volar incision

© 2019 THE AUTHORS. Published by Elsevier Inc. on behalf of The American Guild for Surgery of the Hand.