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The Journal of Bone and Joint Surgery (American) 84:992-998 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.

Scientific Article

Surgical Repair of Acute Traumatic Closed Transection of the Biceps Brachii

John F. Kragh, Jr., LTC MC USA and Carl J. Basamania, LTC (Ret) MC, USA

Investigation performed at the Orthopaedic Service, Department of Orthopaedics and Rehabilitation, Womack Army Medical Center, Fort Bragg, North Carolina

John F. Kragh Jr., LTC, MC, USA
Orthopaedic Service, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234-6200. E-mail address: john.kragh{at}amedd.army.mil

Carl J. Basamania, LTC (Ret), MC, USA
Division of Orthopaedic Surgery, Department of Surgery, Duke University Medical Center, DUMC 3531, Durham, NC 27710. E-mail address: cbasam@surgical.net

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

A video supplement to this article is available from the Video Journal of Orthopaedics. A video clip is available at the JBJS web site, www.jbjs.org. The Video Journal of Orthopaedics can be contacted at (805) 962-3410, web site: www.vjortho.com.

Background: Effective techniques to repair transected muscles are not well described. We determined the outcome of surgically repaired closed transections of the biceps muscle with regard to strength, appearance, and patient satisfaction.

Methods: We conducted a study on surgical repair of acute traumatic closed transection of the muscle belly of the biceps brachii in paratroopers. Muscle fibers and epimysium were sutured with use of running interlocked stitches as well as modified Mason-Allen stitches. We gathered data on the supination torque, appearance of the arm, and patient satisfaction. Nine patients underwent surgical repair and were followed for a mean of 2.2 years. Three patients, who constituted a comparative group, had nonoperative treatment of complete transections of the biceps and were followed for a mean of eleven years.

Results: We found that the patients who had surgical repair had better results than did those who had nonoperative treatment, with respect to supination torque (a mean of 11.0 N-m compared with 5.8 N-m, p = 0.0005), appearance (a mean of 4.6 cm compared with 3.0 cm, according to the cosmetic visual analog scale; p = 0.000002), and satisfaction (excellent in all nine patients who had surgical repair and satisfactory in all three who had nonoperative treatment).

Conclusions: The results after repair of acute traumatic closed transection of the biceps brachii with the new surgical technique described in the present study demonstrated a significant improvement in terms of function, appearance, and patient satisfaction compared with those after nonoperative treatment.


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