Results of surgical treatment of distal biceps tendon ruptures

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.