Distal biceps repair is a procedure done after suffering an injury to the biceps tendon near the elbow. The distal biceps is typically injured when attempting to lift something heavy, or in patients who are trying to slow the fall of a heavy object. The tendon typically ruptures at its insertion into the radius. When the tendon is injured patients experience pain and weakness that may not improve without surgery. Distal biceps repair can give patients relief from pain and weakness.
Patients who have a distal biceps rupture experience difficulty bending their elbow or rotating their forearm. Other signs are bruising on the forearm or the front of the elbow, where the biceps inserts into the bone. The biceps muscle will appear shortened, and balled up, indicating a tear in the tendon near the elbow.
Tendons in your body attach muscles to bone. The biceps muscle and tendon span the distance from the shoulder to the forearm. The biceps are anchored at the shoulder by two separate tendons and to the forearm by another tendon. When the biceps muscle contracts, this tendon transmits the force from the muscle across the elbow joint, causing the elbow to flex. When the tendon tears completely it no longer attaches to the bone and movement is impaired.
Distal biceps repair for a distal biceps tear is typically surgical. Occasionally patients will elect a non-surgical treatment option; however they can expect to have significant weakness in the future. When we perform surgery to fix a distal biceps, we anchor the tendon down to the bone with very strong suture. Surgical management of a distal biceps tear is best when it occurs within the first two weeks after the injury. In instances where treatment is delayed, we occasionally will utilize a cadaver tendon to help with our repair.
After surgery for distal biceps rupture the arm is splinted and wrapped for two weeks. A hinged elbow brace is then worn to protect our repair. Gentle range of motion is begun at that time with the goal of returning to full range of motion by 6-8 weeks after surgery. Patients begin physical therapy around 6 weeks, and strengthening at three months after their operation. Most patients are completely better 6 months after surgery.