The Journal of Bone and Joint Surgery (American). 2007;89:1044-1049.
doi:10.2106/JBJS.D.02992
© 2007 The Journal of Bone and Joint Surgery, Inc.
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 Shoulder/Elbow Test 18: Summer 2007 (publication date August 15, 2007; expi...
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Distal Biceps Tendon Anatomy: A Cadaveric Study

M.H.A. Eames, MD1, G.I. Bain, MD2, Q.A. Fogg, MD3 and R.P. van Riet, MD, PhD4

1 Modbury Public Hospital, Smart Road, Modbury, SA 5092, Australia
2 196 Melbourne Street, North Adelaide, South Australia 5006. E-mail address: greg{at}gregbain.com.au
3 Department of Anatomical Sciences, University of Adelaide SA 5005, Australia
4 Department of Orthopaedic Surgery and Trauma, University Hospital Antwerp, Wilrijkstraat 10, Edegem 2650, Belgium

Investigation performed at Modbury Public Hospital, Modbury, South Australia, Australia

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received 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, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Background: The anatomy of the distal biceps tendon and aponeurosis has not been studied in detail.

Methods: Seventeen cadaver elbows were dissected with loupe magnification to identify the details of the distal biceps tendon and the lacertus fibrosus.

Results: In ten of the seventeen specimens, the distal biceps tendon was in two distinct parts, each a continuation of the long and short heads of the muscle. The remaining seven specimens showed interdigitation of the muscle distally. The tendon continued from each muscle belly. The short head inserted distal to the radial tuberosity and was positioned to be a more powerful flexor of the elbow, while the tendon of the long head inserted on the tuberosity further from the axis of rotation of the forearm and was positioned to be a stronger supinator. The bicipital aponeurosis consisted of three layers and completely encircled the ulnar forearm flexor muscles. The aponeurosis may be important in stabilizing the tendons distally.

Conclusions: The double tendon insertion may allow an element of independent function of each portion of the biceps, and, during repair of an avulsion, the surgeon should ensure correct orientation of both tendon components.


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