Closed Midsubstance Rupture of the Biceps Brachii and Brachialis: A Case Report

Closed rupture of the biceps brachii muscle belly should be considered in patients who experience arm pain and weakness after a forceful extension of the elbow against a fixed point of compression in the mid-arm. A delayed or missed diagnosis may portend inferior outcomes. Magnetic resonance imaging (MRI) can confirm the diagnosis but may not fully define the lesion. Therefore, the treating physician should be fully prepared to encounter a greater magnitude of muscular injury than that defined by the MRI. In young, active patients, early surgical repair can be considered to optimize the strength and cosmetic appearance of the limb. The repair technique should consist of a self-grasping suture technique, which may need to be augmented by fascial flaps or allograft tissue.