Results of surgical treatment of distal biceps tendon ruptures

Authors

DOI:

https://doi.org/10.14739/2310-1210.2022.6.261148

Keywords:

wounds and injuries, tendon injuries, musculus biceps brachii, surgical treatment

Abstract

Rupture of the distal biceps tendon is an injury that most often affects men of working age, so the time and quality of rehabilitation is of great socio-economic importance. Conservative treatment in most cases is impractical, as it leads to a significant increase in treatment time and period of incapacity and does not provide a satisfactory recovery of functions. The main problems of surgical treatment of the distal biceps tendon rupture of the shoulder are considered in the article. Today, there are many methods of surgical treatment, including anchor fixation to the hump of the radial bone; fixation of the distal biceps tendon by using an oval-shaped cortical button fixator, etc. The article presents the main methods of treatment, their advantages and disadvantages.

The aim of the study. To improve the results of surgical treatment of distal biceps brachii tendon rupture by reducing the recovery time and reducing the proportion of complications using a modified technique of button fixation.

Materials and methods. The study was performed by retrospective analysis of the surgical treatment results of 35 patients with fresh rupture of the distal biceps tendon, who were divided into two groups – operated with anchor fixator (n = 15) and cortical button fixator (n = 20). Functional outcomes were assessed by the DASH scale in 3 days, 2 weeks, 6 weeks and 3 months after the intervention; pain intensity was measured by the Visual Analogue Scale (VAS) after 3 days and 2 weeks at rest, after 6 weeks and 3 months – during exercise; the time of surgery was evaluated.

Results. There was a statistically significant improvement in the DASH score at 6 weeks and 3 months after intervention in the cortical fixator group (P = 0.008 and P = 0.003, respectively). Cortical fixation surgery required less surgical time (P = 0.0016) and was accompanied by less pain in the early postoperative period (P = 0.0015).

Conclusions. Surgical intervention with the proposed method takes less operating time, requires a shorter period of immobilization, is accompanied by lower risks for loss of the retainer stability. Features of the proposed intervention technique avoid heterotopic ossification. Early onset of active movements can accelerate the functional restoration of the injured limb. Surgical intervention with the proposed method requires less surgical access, accompanied by lower pain intensity in the early postoperative period.

Author Biographies

M. S. Lisunov, Zaporizhzhia State Medical University, Ukraine

MD, Senior Laboratory Assistant of the Department of Orthopedics and Traumatology

M. L. Holovakha, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Orthopedics and Traumatology

M. O. Kozhеmiaka, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Associate Professor of the Department of Traumatology and Orthopedics

References

Safran, M. R., & Graham, S. M. (2002). Distal biceps tendon ruptures: incidence, demographics, and the effect of smoking. Clinical orthopaedics and related research, (404), 275-283.

Launonen, A. P., Huttunen, T. T., Lepola, V., Niemi, S. T., Kannus, P., Felländer-Tsai, L., Berg, H. E., Laitinen, M. K., & Mattila, V. M. (2020). Distal Biceps Tendon Rupture Surgery: Changing Incidence in Finnish and Swedish Men Between 1997 and 2016. The Journal of hand surgery, 45(11), 1022-1028. https://doi.org/10.1016/j.jhsa.2020.07.024

Stoll, L. E., & Huang, J. I. (2016). Surgical Treatment of Distal Biceps Ruptures. The Orthopedic clinics of North America, 47(1), 189-205. https://doi.org/10.1016/j.ocl.2015.08.025

Morrey, M. E., Abdel, M. P., Sanchez-Sotelo, J., & Morrey, B. F. (2014). Primary repair of retracted distal biceps tendon ruptures in extreme flexion. Journal of shoulder and elbow surgery, 23(5), 679-685. https://doi.org/10.1016/j.jse.2013.12.030

Legg, A. J., Stevens, R., Oakes, N. O., & Shahane, S. A. (2016). A comparison of nonoperative vs. Endobutton repair of distal biceps ruptures. Journal of shoulder and elbow surgery, 25(3), 341-348. https://doi.org/10.1016/j.jse.2015.10.008

Hansen, G., Smith, A., Pollock, J. W., Werier, J., Nairn, R., Rakhra, K. S., Benoit, D., & Papp, S. (2014). Anatomic repair of the distal biceps tendon cannot be consistently performed through a classic single-incision suture anchor technique. Journal of shoulder and elbow surgery, 23(12), 1898-1904. https://doi.org/10.1016/j.jse.2014.06.051

Kelly, M. P., Perkinson, S. G., Ablove, R. H., & Tueting, J. L. (2015). Distal Biceps Tendon Ruptures: An Epidemiological Analysis Using a Large Population Database. The American journal of sports medicine, 43(8), 2012-2017. https://doi.org/10.1177/0363546515587738

Dyussenbayev, A. (2017). Age Periods Of Human Life. Advances in Social Sciences Research Journal, 4(6). https://doi.org/10.14738/assrj.46.2924

Freeman, C. R., McCormick, K. R., Mahoney, D., Baratz, M., & Lubahn, J. D. (2009). Nonoperative treatment of distal biceps tendon ruptures compared with a historical control group. The Journal of bone and joint surgery. American volume, 91(10), 2329-2334. https://doi.org/10.2106/JBJS.H.01150

Witkowski, J., Kentel, M., Królikowska, A., & Reichert, P. (2016). A Retrospective Evaluation of Anatomical Reinsertion of the Distal Biceps Brachii Tendon Using an ACL TightRope® RT with a Titanium Cortical Button and Ultra High Molecular Weight Polyethylene Suture: A Preliminary Report. Polimery w Medycynie, 46(2), 163-169. https://doi.org/10.17219/pim/0000

Carter, T. H., Karunaratne, B. J., Oliver, W. M., Murray, I. R., White, T. O., Reid, J. T., & Duckworth, A. D. (2021). Acute distal biceps tendon repair using cortical button fixation results in excellent short- and long-term outcomes : a single-centre experience of 102 patients. The bone & joint journal, 103-B(7), 1284-1291. https://doi.org/10.1302/0301-620X.103B7.BJJ-2020-2246.R1

Legg, A. J., Stevens, R., Oakes, N. O., & Shahane, S. A. (2016). A comparison of nonoperative vs. Endobutton repair of distal biceps ruptures. Journal of shoulder and elbow surgery, 25(3), 341-348. https://doi.org/10.1016/j.jse.2015.10.008

Gavrilă, T. M., & Cristea, Ștefan. (2018). Open versus arthroscopic surgery in acromioclavicular separation. Journal of Clinical and Investigative Surgery, 3(2), 82-87. https://doi.org/10.25083/2559.5555/3.2/82.87

Flinkkilä, T., Heikkilä, A., Sirniö, K., & Pakarinen, H. (2015). TightRope versus clavicular hook plate fixation for unstable distal clavicular fractures. European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 25(3), 465-469. https://doi.org/10.1007/s00590-014-1526-9

Cao, Y., Xu, Y., Hong, Y., & Xu, X. (2018). A new minimally invasive method for anatomic reconstruction of the lateral ankle ligaments with a Tightrope system. Archives of orthopaedic and trauma surgery, 138(11), 1549-1555. https://doi.org/10.1007/s00402-018-2955-4

Pochini, A. C., Rodrigues, M., Yamashita, L., Belangero, P. S., Andreoli, C. V., & Ejnisman, B. (2017). Surgical treatment of pectoralis major muscle rupture with adjustable cortical button. Revista brasileira de ortopedia, 53(1), 60-66. https://doi.org/10.1016/j.rboe.2017.11.005

Witkowski, J., Królikowska, A., Czamara, A., & Reichert, P. (2017). Retrospective Evaluation of Surgical Anatomical Repair of Distal Biceps Brachii Tendon Rupture Using Suture Anchor Fixation. Medical science monitor, 23, 4961-4972. https://doi.org/10.12659/msm.903723

Holovakha, M. L., Kozhemiaka, M. O., Lisunov, M. S., & Bohdan, O. V. (2020) Sposib fiksatsii dystalnoho sukhozhylka bitsepsa pry yoho rozryvi [Method of fixation of the distal biceps tendon rupture]. Ukraine Patent UA 144648. https://sis.ukrpatent.org/uk/search/detail/1458389/

McKeon, B. P., Heming, J. F., Fulkerson, J., & Langeland, R. (2006). The Krackow stitch: a biomechanical evaluation of changing the number of loops versus the number of sutures. Arthroscopy, 22(1), 33-37. https://doi.org/10.1016/j.arthro.2005.10.008

Langley, G. B., & Sheppeard, H. (1985, July). The visual analogue scale: Its use in pain measurement. Rheumatology International, 5(4), 145-148. https://doi.org/10.1007/BF00541514

Aasheim, T., & Finsen, V. (2014). The DASH and the QuickDASH instruments. Normative values in the general population in Norway. The Journal of hand surgery, European volume, 39(2), 140-144. https://doi.org/10.1177/1753193413481302

Dunphy, T. R., Hudson, J., Batech, M., Acevedo, D. C., & Mirzayan, R. (2017). Surgical Treatment of Distal Biceps Tendon Ruptures: An Analysis of Complications in 784 Surgical Repairs. American Journal of Sports Medicine, 45(13), 3020-3029. https://doi.org/10.1177/0363546517720200

Published

2022-12-20

How to Cite

1.
Lisunov MS, Holovakha ML, Kozhеmiaka MO. Results of surgical treatment of distal biceps tendon ruptures. Zaporozhye Medical Journal [Internet]. 2022Dec.20 [cited 2024Dec.28];24(6):714-20. Available from: http://zmj.zsmu.edu.ua/article/view/261148

Issue

Section

Original research