Delayated distal biceps rupture - SECEC 2014

Delayated distal biceps rupture : interest of an endoscopic double row repair about 5 cases.

P.Croutzet, J.Kany, R. Guinand
Société Européenne pour la Chirurgie de l'Epaule et du Coude – Istanbul, Septembre 2014

 

Introduction

Endoscopic repair of distal biceps rupture was a major involvement in acute rupture. Unfortunately, diagnosis difficulties lead to delayed care.

Goal

Our goal was to use a double row endoscopic repair to improve delayed distal biceps rupture.

Method

This case series concerns all the delayed ruptures operated from 6 to 10 weeks after the trauma, over a 2-year period. We used a 3 to 5cm volar incision, 4mm arthroscope, 2 anchors (3mm & 4mm) positioned in a “double row” position, splint in flexion-suppination for 6 weeks, passive physiotherapy after 3 weeks.

Physical examination were done after 3, 6 and 12 weeks. Analysis criteria were:
-peroperative: ability to release the tendon, gap distance between bone and tendon after repair
-post-operative: motion(F/E, P/S) at 3 months, pain, time without working and sports

Results

- Peroperative : Releasing the tendon was the longest part of the procedure. In order to improve tendon reduction, the tourniquet had to be switched off during the repair. The gap distance was 0mm in 3 cases, 5mm in 4 cases and 1 cm in one case.
- Post-operative : Biceps tendon was always palpable after 3 months, no pain, full motion in 4 cases : one case had a lack of extension-pronation (30°).
Time without working was 7 weeks (3-10)

 

Conclusion

It was possible to repair the tendon in all cases. Tendon healing was always possible enabling functional motion in all cases. Considering the only case of partial stiffness, it is reliable to endeavour to repair delayed ruptures (up to 10 weeks) straight to the radius.

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