[Refixation of distal biceps tendon rupture using 2 anchor sutures - sports ability after 1 year follow-up and operative technique].

Abstract

Background: Rupture of distal biceps tendon often occurs in physical active male persons between 30 and 50 years. The standard treatment consists of operative refixation of the ruptured tendon stump. In literature there are various methods described. Due to the high expectations of this group of patients, we examined the sports ability after 1 year follow-up and describe our employed operative fixation technique.

Material: Between 2004 and 2008 we treated 20 male persons in a prospective study with distal biceps tendon rupture. Applying the score of Rattanen and Orawa we evaluated the M. biceps force in flexion and supination and changes in the patients' sports activity. Furthermore we documented complications and the anchor localization via x-ray.

Results: The score results varied between excellent in 14 patients and good and fair in 3 cases respectively. Using only 1 suture anchor (3 patients), either a knot or a wire failure appeared within 5 days. Anchor malpositions were discovered in 2 patients. The force measurement showed threetimes minor but in 3 patients major force deficits. Lack of extension or supination movement could be stated in 3 cases. Changes in their sports ability reported 8 persons. Of the remaining 12 patients, the original sports level was reached after 9 months.

Conclusion: Two anchors proved to guarantee a stable fixation of the distal biceps tendon stump. On the contrary we see the danger of fixation failure in using only 1 anchor. The best results achieved patients with a primer stable and correct located anchoring, therefore we recommend two anchors placed under radiological control. Regarding the score results, fixation of the distal biceps tendon is a demanding procedure, that should be performed by experienced surgeon.