I do many distal biceps tendon repairs every year. I have only recently performed these repairs through a single incision with an endobutton (a special kind of anchor device which holds the tendon to the bone) with great success. I had one case where the endobutton would not hold the tendon in place and I had to resort to the standard technique. That case turned out well but proved to me that new technology is not always better and you always have to have a plan B if plan A does not work. After 20 years of experience, I had a plan B and beyond. For years, however, I only performed these biceps ruptures from the elbow through a 2 incision technique. I believed that the research and my experience confirmed that the 2 incision technique was the gold standard with the lowest rate of complications. The below study seems to confirm that premise. I would still use the single incision technique in selected cases.
Read on from the AAOS...
Patients treated with double-incision repair using transosseous drill holes for acute distal biceps rupture may see fewer complications than those treated with single-incision repair using suture anchors, according to the results of a prospective, randomized clinical trial presented at the 2010 ASSH annual meeting.
|An intra operative photo of a single incision repair using endobutton anchor. This ruptured tendon will be reinserted into the bone.|
|The perfect repair.|
No overall differences in functional outcomes were found between distal biceps ruptures treated with either a single or double incision repair technique; however flexion strength was slightly greater with a two-incision technique.
- The single-incision group had a greater incidence of complications.