Acute Distal Biceps Tendon Repair With Cortical Button Offers Good Functional Outcomes: A Retrospective Study Focusing on Range of Motion, Muscle Strength and Pain

TL;DR

This study shows that using cortical buttons to repair a torn distal biceps tendon leads to good recovery of elbow function and strength.

Contribution

The study provides new evidence on the effectiveness of cortical button fixation for distal biceps tendon repair.

Findings

Patients had excellent functional outcomes with a mean Mayo Elbow Performance Score of 91.43 at 6 months.

Supination strength was notably restored, and pain levels were low (mean VAS score of 0.54).

Range of motion showed minimal extension deficit and good flexion and supination.

Abstract

Background

Distal biceps tendon (DBT) rupture is not one of the most common upper limb injuries. Surgical intervention is recommended for these injuries to restore muscular strength and functionality. Multiple different techniques are documented in the literature, however there is no definitive consensus on the most effective surgical treatment. The objective of this study was to assess the functional results of patients who underwent repair of DBT utilizing cortical button fixation procedures.

Methods

This study is a retrospective single-unit case series consisting of 54 patients who underwent DBT repair at Heartlands Hospital in Birmingham, United Kingdom. The patients' functional outcomes was assessed by the Mayo Elbow Performance Score (MEPS).

Results

The mean age was 51±11.01 years. Patients were operated on 4.72±7.083 days after the injury. The mean pain Visual Analogue Scale (VAS) 6 months after the surgery was 0.54±0.50.

At 6 months follow-up, the average extension deficit was 2.69° (0-10), flexion 132° (120-140), supination76° (50- 85), and 77° for pronation (78-95). Patients were followed up routinely for 6 months. Mayo Elbow Performance (MEP) Score was utilized to assess the functional outcome and the mean MEP score was 91.43±8.26 which showed excellent functional outcomes for the cohort.

Conclusion

DBT repair with cortical button fixation yielded favorable functional outcomes at 6 months, notably restoring supination strength. This approach offers anatomical reinsertion while minimizing nerve damage risk.