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.
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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