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Anatomic Transosseous Suture Fixation of the Distal Biceps Tendon Using a Single-Incision Approach

March 01, 2019

Contributors: Khusboo Desai, MD; Shazaan Hushmendy, MD; Andrew Steven Morse, MD; Elaine Tran, MD; Elaine Tran, MD

The annual incidence of distal biceps tendon rupture is 1.2 per 100,000 individuals. Distal biceps tendon ruptures more commonly occur in the dominant extremity of middle-aged males as a result of eccentric loading. Active individuals with a complete rupture benefit from surgical reattachment, which results in improved strength with forearm supination and elbow flexion. In the past two decades, numerous approaches and fixation techniques for the management of distal biceps tendon rupture have been developed, including single- and dual-incision approaches and surgical fixation using a cortical button, intraosseous screws, suture anchors, or bone tunnel techniques. As a result of increased understanding of the clinical importance of the biceps footprint, surgical techniques focus on anatomic reattachment to the radial tuberosity. This video shows anatomic transosseous suture fixation of the distal biceps tendon using a single-incision anterior approach. A case series that used a similar technique reported excellent postoperative supination strength, decreased pain, and increased rates of return to work and normal activities. The distal biceps tendon can be repaired many ways. The surgical technique presented in this video achieves anatomic reconstruction using a single-incision approach.