Clinical Trial Study
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2014; 2(8): 357-361
Published online Aug 16, 2014. doi: 10.12998/wjcc.v2.i8.357
Distal biceps tendon rupture reconstruction using muscle-splitting double-incision approach
Luigi Tarallo, Raffaele Mugnai, Francesco Zambianchi, Roberto Adani, Fabio Catani
Luigi Tarallo, Raffaele Mugnai, Francesco Zambianchi, Fabio Catani, Orthopaedics and Traumatology Department, Modena Policlinic, University of Modena and Reggio Emilia, 41124 Modena, Italy
Roberto Adani, Department of Hand Surgery and Microsurgery, University Hospital of Verona, 37134 Verona, Italy
Author contributions: Tarallo L and Adani R designed the research; Tarallo L, Adani R and Catani F performed the research; Mugnai R collected the data; Mugnai R and Zambianchi F wrote the paper.
Correspondence to: Raffaele Mugnai, MD, Orthopaedics and Traumatology Department, Modena Policlinic, University of Modena and Reggio Emilia, Modena, Via del Pozzo 71, 41124 Modena, Italy. raffaele.mugnai@gmail.com
Telephone: +39-59-4224916 Fax: +39-59-4224313
Received: April 5, 2014
Revised: June 21, 2014
Accepted: July 17, 2014
Published online: August 16, 2014
Abstract

AIM: To evaluate the clinical and functional results after repair of distal biceps tendon tears, following the Morrey’s modified double-incision approach.

METHODS: We retrospectively reviewed 47 patients with distal rupture of biceps brachii treated between 2003 and 2012 in our Orthopedic Department with muscle-splitting double-incision technique. Outcome measures included the Mayo elbow performance, the DASH questionnaire, patient’s satisfaction, elbow and forearm motion, grip strength and complications occurrence.

RESULTS: At an average 18 mo follow-up (range, 7 mo-10 years) the average Mayo elbow performance and DASH score were respectively 97.2 and 4.8. The elbow flexion range was 94%, extension was -2°, supination was 93% and pronation 96% compared with the uninjured limb. The mean grip strength, expressed as percentage of respective contralateral limb, was 83%. The average patient satisfaction rating on a Likert scale (from 0 to 10) was 9.4. The following complications were observed: 3 cases of heterotopic ossification (6.4%), one (2.1%) re-rupture of the tendon at the site of reattachment and 2 cases (4.3%) of posterior interosseous nerve palsy. No complication required further surgical treatment.

CONCLUSION: This technique allows an anatomic reattachment of distal biceps tendon at the radial tuberosity providing full functional recovery with low complication rate.

Keywords: Distal biceps tendon, Rupture, Double incision, Complications, Clinical outcome, Trans-osseous tunnels, Morrey

Core tip: Both single and double-incision approaches have been successfully used for distal biceps tendon lesions. At present there is no solid scientific evidence to support preference of one technique over the other. However, recently, it has been demonstrated that the 2-incision technique recreates more closely footprint position compared with that of the 1-incision approach. In the present research the Morrey’s modified double-incision repair provided excellent outcome (including functional outcome, satisfaction, elbow and forearm motion, and grip strength) with few post-operative complications, mainly represented by heterotopic ossification and posterior interosseous nerve injuries.