This Article Full Text Full Text (PDF) Letters to the Editor: Submit a response Letters to the Editor: View responses Alert me when this article is cited Alert me when Letters to the Editor are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kelly, E. W. Articles by O'Driscoll, S. W. Search for Related Content PubMed PubMed Citation Articles by Kelly, E. W. Articles by O'Driscoll, S. W. Social Bookmarking                   What's this?

Complications of Repair of the Distal Biceps Tendon with the Modified Two-Incision Technique*

Edward W. Kelly, M.D., Bernard F. Morrey, M.D. and Shawn W. O'Driscoll, Ph.D., M.D.

Investigation performed at the Department of Orthopedics, Mayo Clinic, Rochester, Minnesota
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.
Read in part on Specialty Day of the American Shoulder and Elbow Surgeons and at the Annual Meeting of the American Academy of Orthopaedic Surgeons, Anaheim, California, February 8, 1999.
Department of Orthopedics, Mayo Clinic, 200 First Street S.W., Rochester, Minnesota 55905. E-mail address for B. F. Morrey: morrey.bernard{at}mayo.edu E-mail address for S. W. O'Driscoll: odriscoll.shawn@mayo.edu.

Background: The purpose of this paper is to describe the complications that we encountered after using a muscle-splitting two-incision technique to repair avulsed distal biceps tendons.

Methods: We conducted a retrospective review of the results of seventy-eight consecutive anatomical repairs of the distal biceps tendon performed through a muscle-splitting two-incision technique at our institution between 1981 and 1998. Four of the patients required a graft to restore length. The seventy-four tendons that were repaired primarily through the modified Boyd-Anderson approach were analyzed in detail and form the basis of this report.

Results: Complications developed after twenty-three (31 percent) of the seventy-four repairs. The complications included five sensory nerve paresthesias (three lateral antebrachial cutaneous and two superficial radial nerve paresthesias) in five patients. A temporary palsy of the posterior interosseous nerve developed in one patient; it resolved in six months. Six patients complained of persistent anterior elbow pain. Heterotopic ossification that did not limit forearm rotation developed in four patients, a superficial wound infection developed in three, one tendon reruptured, three patients lost forearm rotation, and reflex sympathetic dystrophy developed in one patient. No radioulnar synostoses were observed in our series. Complications developed after ten (24 percent) of the forty-one acute repairs (performed fewer than ten days after the injury), six (38 percent) of the sixteen subacute repairs (performed ten to twenty-one days after the injury), and seven (41 percent) of the seventeen delayed repairs (performed more than twenty-one days after the injury). The surgeon's experience with this procedure had no apparent effect on complication rates.

Conclusions: Most of the morbidity from repair of the distal biceps tendon can be attributed primarily to a delay in the timing of the repair and secondarily to an extensive anterior exposure. More importantly, radioulnar synostosis is rare following the muscle-splitting modification of the two-incision technique, which can be performed safely even by surgeons with limited experience with this procedure.

CiteULike    Connotea    Del.icio.us    Facebook    Technorati    Twitter    What's this?

This article has been cited by other articles:

				C. M. Jobin, M. A. Kippe, T. R. Gardner, W. N. Levine, and C. S. Ahmad Distal Biceps Tendon Repair: A Cadaveric Analysis of Suture Anchor and Interference Screw Restoration of the Anatomic Footprint Am. J. Sports Med., November 1, 2009; 37(11): 2214 - 2221. [Abstract] [Full Text] [PDF]

				C. R. Freeman, K. R. McCormick, D. Mahoney, M. Baratz, and J. D. Lubahn Nonoperative Treatment of Distal Biceps Tendon Ruptures Compared with a Historical Control Group J. Bone Joint Surg. Am., October 1, 2009; 91(10): 2329 - 2334. [Abstract] [Full Text] [PDF]

				A. D. Heinzelmann, F. H. Savoie III, J. R. Ramsey, L. D. Field, and A. D. Mazzocca A Combined Technique for Distal Biceps Repair Using a Soft Tissue Button and Biotenodesis Interference Screw Am. J. Sports Med., May 1, 2009; 37(5): 989 - 994. [Abstract] [Full Text] [PDF]

				A. Cil, S. Merten, and S. P. Steinmann Immediate Active Range of Motion After Modified 2-Incision Repair in Acute Distal Biceps Tendon Rupture Am. J. Sports Med., January 1, 2009; 37(1): 130 - 135. [Abstract] [Full Text] [PDF]

				P. R. Chavan, T. R. Duquin, and L. J. Bisson Repair of the Ruptured Distal Biceps Tendon: A Systematic Review Am. J. Sports Med., August 1, 2008; 36(8): 1618 - 1624. [Abstract] [Full Text] [PDF]

				J. Henry, J. Feinblatt, C. C. Kaeding, J. Latshaw, A. Litsky, R. Sibel, J. A. Stephens, and G. L. Jones Biomechanical Analysis of Distal Biceps Tendon Repair Methods Am. J. Sports Med., November 1, 2007; 35(11): 1950 - 1954. [Abstract] [Full Text] [PDF]

				S. W. O'Driscoll, L. B. J. Goncalves, and P. Dietz The Hook Test for Distal Biceps Tendon Avulsion Am. J. Sports Med., November 1, 2007; 35(11): 1865 - 1869. [Abstract] [Full Text] [PDF]

				A. D. Mazzocca, K. J. Burton, A. A. Romeo, S. Santangelo, D. A. Adams, and R. A. Arciero Biomechanical Evaluation of 4 Techniques of Distal Biceps Brachii Tendon Repair Am. J. Sports Med., February 1, 2007; 35(2): 252 - 258. [Abstract] [Full Text] [PDF]

				C. S. Idler, W. H. Montgomery III, D. P. Lindsey, P. A. Badua, G. F. Wynne, and S. A. Yerby Distal Biceps Tendon Repair: A Biomechanical Comparison of Intact Tendon and 2 Repair Techniques Am. J. Sports Med., June 1, 2006; 34(6): 968 - 974. [Abstract] [Full Text] [PDF]

Letters to the Editor:

Stanford University Libraries' HighWire Press (TM) assists in the publication of JBJS Online.
Copyright © 2000 by The Journal of Bone and Joint Surgery, Inc. Online ISSN: 1535-1386.
The Journal of Bone and Joint Surgery®, JBJS®, JB&JS®, and eJBJS® are registered in the U.S. Patent and Trademark Office.