Distal biceps rupture

Diagnosis of distal biceps rupture:

Although ultrasound scans can contribute to the diagnosis, the best examination to confirm distal biceps rupture at the elbow is a bilateral and comparative clinical examination conducted by an experienced surgeon who will ascertain the absence of the tendon by palpating the elbow held in flexion and detect a sore spot at the middle third of the arm, corresponding to the tendon stump of the biceps, which is recoiled. 

Video of distal biceps rupture treatment:

Elbow surgery video showing endoscopic distal biceps repair surgery / Toulouse specialist

Definition of distal biceps rupture:

This surgical procedure is specialized surgery. The surgery is performed on an outpatient basis under regional anaesthesia, with the patient comfortably positioned in the supine. On this arthroscopic surgery photo the surgeon stands by the head of the patient. The Fluoroscan is at his feet.
Using the camera, the surgeon confirms that the tendon sheath is empty and direct avulsion of the radial tuberosity (also called bicipital tuberosity).  

The biceps has two tendons at the shoulder but only one at the elbow, hence its relative fragility at the latter’s extremity.Endoscopic distal biceps reinsertion surgery, operative setup, Toulouse

 

Surgical treatment of distal biceps rupture:

The first anchor is placed on the medial part of the radial tuberosity with the arm held fully supine, completely buried to prevent interference, then the surgeon places a second, more distal anchor.

Endoscopic distal biceps reinsertion surgery, vacant radial tuberosity, ToulouseEndoscopic distal biceps reinsertion surgery, verification of first anchor’s placement, Toulouse

The tendon is tied using a triple sliding suture, then the surgeon takes the biceps tendon down onto the tuberosity under endoscopic monitoring, confirming contact between the tendon and the bone is satisfactory and the suture solid.

Endoscopic distal biceps reinsertion surgery, verification of second anchor’s positioning, ToulouseEndoscopic distal biceps reinsertion surgery, verification of tendon reinsertion and satisfactory tendon-bone contact

This is the post-operative x-ray of the elbow and the cosmetic and functional result, with full mobility and one scar hidden in the flexion crease of the elbow

Endoscopic distal biceps reinsertion surgery, Toulouse

Endoscopic distal biceps reinsertion surgery, postoperative x-ray confirming perfect positioning of the anchors, ToulouseEndoscopic distal biceps reinsertion surgery, scar at 1 month hidden in elbow’s flexion crease, Toulouse

 

Recovery after surgery for distal biceps rupture

Elbow immobilization will be necessary for 6 weeks. Elbow rehabilitation will start 3 weeks after surgery, biceps strengthening after 2 months and matches after 3 months.

Endoscopic distal biceps reinsertion surgery, training resumes at 2 months and matches at 3 months, Toulouse