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Distal Biceps Tendon Repair

The biceps muscle is located in front of your upper arm. It helps in bending your elbow as well as rotational movements of your forearm. The biceps muscle attaches to the shoulder and the other attaches at the elbow. The biceps tendon at the elbow is called the distal biceps tendon and if there is a tear in this tendon, you will be unable to move your arm from the palm-down to palm-up position. Once the distal biceps tendon is torn, it cannot regrow back to the bone and heal by itself. Weakness during rotatory movements of the forearm will occur if the tendon is not repaired surgically.

There are several procedures to accomplish reattachment of the distal biceps tendon to the forearm bone. Professor Bain developed the one incision Endobutton technique. The tendon is reattached using stitches passed through holes drilled in the bone. A small metal implant, the endobutton is used to attach the tendon.

Surgical technique

During distal biceps tendon repair, a small incision over the upper forearm, where the biceps muscle attaches to the radius bone. A telescope can be inserted to visualise the torn tendon, bursa and radius attachment. The torn biceps tendon is brought up through the incision. Then, the radius bone is prepared for tendon reattachment and to promote healing. An endobutton will be inserted into the bone to serve as anchorage for the tendon. The sutures from the suture anchors are passed through the tendon in an interlocking manner so as to ensure a strong tendon repair.

After the surgery

After the repair is complete, a dressing is sometimes applied. A brace is worn with up to 6months -1 year to regain full strength.

Risks and Complications
Complications are rare and may include numbness and weakness in the forearm, formation of new bone, limited movement, and re-tearing around the radius and ulna, may occur. Rarely there can be injury to major nerves and vessels.