Distal Biceps Tendon Rupture
What is a Distal Biceps Tendon Rupture?
What is a Distal Biceps Tendon Rupture?
The distal tendon of the biceps brachii is a poorly vascularized tendon that inserts into the tuberosity of the radius and has a dual function: supination of the forearm and flexion of the elbow. This condition is practically exclusive to men of working age and rupture of this tendon generally occurs by an avulsion mechanism near its insertion into the distal radius.
Mechanism of injury
Mechanism of injury
Distal biceps tendon rupture or avulsion occurs when there is a contraction of the biceps brachii, but instead of there being a movement of supination of the forearm or flexion of the elbow, exactly the opposite movement occurs, extension of the elbow and/or pronation of the forearm.
We call this movement an eccentric contraction and, therefore, the injury occurs through an eccentric overload mechanism.
Diagnosis of Distal Biceps Tendon Rupture
Diagnosis of Distal Biceps Tendon Rupture
Physical examination
Physical examination
It is possible to observe a deformity in the arm that we call the Inverted Popeye Sign corresponding to the proximal retraction of the biceps and ecchymosis. In the strength and resistance tests, a 50% decrease in supination strength and approximately 40% in elbow flexion strength are observed.
X-ray
X-ray
It may be requested to exclude other traumatic pathologies.
Magnetic Resonance Imaging
Magnetic Resonance Imaging
It is the examination of choice for diagnosing ruptures and avulsions of the distal biceps tendon and assessing its location and retraction.
Distal Biceps Tendon Rupture Treatment
Distal Biceps Tendon Rupture Treatment
Decision
It fundamentally depends on the patient and the time the injury has been developing.
Conservative
When to perform it? Less active patients who do not mind the aesthetic deformity and who accept the decrease in supination and flexion strength. As well as when several months have passed since the tendon rupture with significant retraction.
Treatment options?
Treatment options?
Physiotherapy with the aim of muscle strengthening.
Surgical
Surgical
When to perform? In most situations.
Procedure/technique – Reinsertion of the tendon into the radial tuberosity
Postoperative
Postoperative
- The patient can be discharged on the same day or the day after surgery.
- Remove the stitches 2 weeks after surgery.
- You can start passive mobility exercises the day after surgery.
How to prevent Distal Biceps Tendon Rupture?
How to prevent Distal Biceps Tendon Rupture?
- Healthy lifestyle.
- Do not use anabolic steroids or smoke.
- Avoid excessive loads in the gym and prefer to increase the number of repetitions.
When to seek an Orthopedic Specialist?
When to seek an Orthopedic Specialist?
You should seek medical advice whenever a rupture of the distal biceps tendon occurs.