Objective. Reinsertion of the distal biceps tendon onto the radial tuberosity restoring full force of ﬂexion and supination. Indications. Distal biceps tendon avulsion from the radial tuberosity. Acute and chronic tears with a tendon stump, which can be mobilized and reduced to the radial tuberosity in ﬂexion and supi- nation. Contraindications. Tears of the musculotendinous junction. Chronic distal biceps tendon tears with wide retraction and the need for tendon graft augmentation. Severe atrophy of the biceps muscle. Surgical technique. In supination, the skin is incised longitudinally for 4 cm, centered over the me- dial border of the radial tuberosity. Incision starts 2 cm distal from the humeroradial joint line. Bluntly the distal biceps tendon stump is found and mobilized. Preparation and debriding of the radial tuberosity sparing neurovascular structures. Crossing vessel branches are ligated, if nee- ded. Positioning of two spreading anchors into the radial tuberosity and reinsertion of the tendon stump. Postoperative management. Adjustable elbow movement orthosis adapted to tendon quality and tis- sue tension for 6 weeks without active ﬂexion or supination. Degree of extension is gradually in- creased by 20° every 2 weeks. After orthosis treatment is ﬁnished aer ft 6 weeks, ﬂexion and supi- nation
Operative Orthopädie und Traumatologie – Springer Journals
Published: May 3, 2017
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