Abstract
Repair of the complete distal biceps rupture may be categorized into acute, delayed, or chronic based upon the time since injury, retraction of the tendon, and quality of the tissue. Techniques for primary repair of the distal biceps tendon rupture include a cortical button interference screw, cortical button and interference screw fixation with the elbow in flexion, a cortical button only, or augmented with either an acellular dermal allograft to provide improved tissue quality or an Achilles tendon allograft to add tendon length. Surgical treatment should attempt to anatomically repair the tendon to the ulnar aspect of the radial tuberosity to increase biomechanical advantage for the supination motion. Soft tissue cortical buttons have been demonstrated to provide superior fixation stiffness in load to failure, and the addition of an interference screw may place the repaired tendon in a more ulnar position on the radial tuberosity and decrease motion within the tunnel. The structural stiffness and strength at time zero allow for early range of motion and decreased heterotopic ossification and postoperative stiffness.
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References
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Declaration of Conflict of Interest
Dr. Augustus D. Mazzocca has received research funding and honorarium from Arthrex, Inc., Naples, FL. Mary Beth R. McCarthy receives intellectual property royalties from Arthrex, Inc. Dr. Megan R. Wolf and Jessica DiVenere have no conflict of interest to disclose.
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Wolf, M.R., McCarthy, M.B.R., DiVenere, J., Mazzocca, A.D. (2020). Distal Biceps Repair: Buttons and Interference Fit Screws. In: Bain, G., Eygendaal, D., van Riet, R. (eds) Surgical Techniques for Trauma and Sports Related Injuries of the Elbow. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-58931-1_65
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DOI: https://doi.org/10.1007/978-3-662-58931-1_65
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