Distal biceps reconstruction using an Achilles tendon allograft, transosseous EndoButton, and Pulvertaft weave with tendon wrap technique for retracted, irreparable distal biceps ruptures
Section snippets
Patients and methods
Twenty-one consecutive patients underwent reconstruction by a single technique performed by or under the direct supervision of the senior author (A.C.W.). All patients were men, and the mean age was 44 years. The indication for reconstruction was a symptomatic, retracted distal biceps rupture that could not be fixed directly to the radial tuberosity using a transosseous EndoButton technique in up to 90° of elbow flexion.
Preoperative demographic data and postoperative outcome scores, range of
Results
Table I shows individual preoperative patient demographic data. The mean follow-up period for the 21 patients was 15 months (range, 6-35 months). The mean age was 44 years (range, 20-62 years). Seventeen patients were right handed, and 11 right arms were treated. Of the patients, 12 had a manual occupation, 8 had a sedentary occupation, and 1 was a rugby player. Seven of the 12 patients with manual jobs were heavy-goods vehicle drivers. In 12 patients, the initial biceps rupture occurred while
Discussion
In this series of 21 patients with retracted, irreparable distal biceps ruptures, we found consistently good functional outcomes, a high level of patient satisfaction, and few complications. The surgical technique described uses an Achilles tendon allograft, EndoButton fixation distally, and a Pulvertaft weave with tendon wrap to secure the graft proximally. The use of Achilles tendon allograft avoids additional graft-site morbidity and is known to have equivalent mechanical properties to
Conclusion
Patients treated with Achilles allograft reconstruction of the distal biceps using an EndoButton and Pulvertaft weave reconstruction with tendon wrap had good clinical results with an improvement in preoperative disability and few complications. This technique is recommended for patients who have a retracted, irreparable distal biceps rupture.
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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Outcomes and complications after different surgical techniques for the treatment of chronic distal biceps tendon ruptures: a systematic review and quantitative synthesis
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2021, Arthroscopy TechniquesOutcomes of chronic distal biceps reconstruction with tendon grafting: a matched comparison with primary repair
2021, JSES InternationalCitation Excerpt :The present study found functional elbow range of motion was reliably restored in patients undergoing allograft reconstruction or direct primary repair. This is consistent with previous reports on elbow range of motion after graft reconstruction.8,10,23,28 Although the present study did not evaluate postoperative elbow strength—previous studies have reported similar restoration of postoperative supination strength between graft reconstruction and direct primary repair.
B2B: A technical note and case report on long head of biceps tendon autograft for chronic distal biceps tendon reconstruction
2021, JSES Reviews, Reports, and Techniques
Institutional review board/ethical committee approval was not required for this study in the United Kingdom because it was a standard follow-up of our clinical results, which we collect on all patients.