Acute distal biceps tendon rupture repair comparing single versus double-incision technique: A retrospective study with follow-up.

Background: Single-incision (SI) and double-incision (DI) techniques are used for acute distal biceps tendon rupture repair. The purpose of this retrospective cohort study with follow-up was to examine if there is a difference between the techniques on early- and long-term outcomes.

Methods: Hospital records from Haukeland University Hospital, Norway, (2007-2017) involving acute distal biceps tendon rupture repair matching inclusion criteria were analysed. Follow-up included assessing symptomatic and functional outcome, quality-of-life outcome (QuickDASH and EQ-5D), visual assessment scale (pain), and subjective health score. A smoking history was obtained.

Results: We included 102 elbows in 100 patients, 99 males. Overall early complication rate was higher for the SI technique compared to the DI technique (25/43 vs. 11/58; p < 0.001). Long-term complications showed no statistically significant difference between the SI and DI technique (12/43 vs. 8/58; p = 0.078). The pronation range of motion favoured the SI technique compared to the DI technique (89.3° vs. 85.1°; p = 0.014). Supination strength favoured the DI technique compared to the SI technique (98.7 vs. 94.5; p = 0.030). Supination strength favoured non-smokers compared to former smokers (99.5 vs. 93.2; p = 0.009). The two techniques had similar quality-of-life outcomes.

Conclusion: The DI technique has a lower risk of short-term complications. Both techniques have comparable symptomatic, functional, and quality-of-life long-term outcomes.