Endobutton Procedure for Distal Biceps Repair


Rupture of the distal biceps brachii tendon is uncommon, accounting for less than 5% of biceps tendon ruptures. The injury typically occurs in middle-aged men as a result of the application of a sudden extension force on a concentrically flexed biceps. Most often, the tendon avulses from its insertion on the radial tuberosity. In this video, Dr. Wolfe performs reattachment of the distal biceps tendon to its radial insertion using a 9-mm Endobutton (Smith&Nephew, Memphis, TN). This procedure allows for a relatively minimal, single anterior incision to reattach the tendon. Additionally, the tendon is secured within the medullary canal of the radius, which enhances the healing potential of the repair. The procedure also provides for extremely secure fixation of the tendon, allowing the patient to have good range of motion and active flexion and supination soon after surgery and, therefore, earlier return to work and activities of daily living. Dr. Wolfe demonstrates his surgical approach and shows how to prepare the ruptured tendon end and attach the Endobutton, drill the cortex of the radius for passage of the tendon, and perform closure of the wound.

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