IntroductionDistal biceps tendon ruptures can be repaired with either a single or a double-incision technique.
Step 1 (Single-Incision Technique): Surgical Exposure and Preparation of the TendonThrough a single anterior incision, identify the tendon and debride the distal degenerated portion.
Step 2 (Single-Incision Technique): Preparation of the RadiusExpose the bicipital tuberosity and prepare the bone for insertion of suture anchors.
Step 3 (Single-Incision Technique): Tendon ReattachmentSuture the tendon with a reduction knot technique that allows for anatomic tendon apposition to bone.
Step 1 (Double-Incision Technique): Surgical Exposure and Preparation of the TendonThrough a small anterior incision retrieve the tendon, debride the distal degenerated portion of the tendon, and place your sutures.
Step 2 (Double-Incision Technique): Preparation of the RadiusThrough a second posterolateral incision, expose the biceps tuberosity and, using a burr, create a trough for the tendon.
Step 3 (Double-Incision Technique): Tendon ReattachmentPass the sutures through the transosseous tunnels and tension the sutures, allowing the biceps tendon to be pulled into the trough created in the bicipital tuberosity, and then tie the sutures.
Step 4: Postoperative CareAssess tension across the repaired tendon, initiate prophylaxis against heterotopic ossification, and begin rehabilitation.
ResultsWe recently conducted a prospective randomized controlled trial at our center comparing the single and double-incision techniques for the repair of acute distal biceps tendon ruptures11.
What to Watch ForIndicationsContraindicationsPitfalls & Challenges