A Retrospective Cohort Study of Distal Biceps Brachii Tendon Rupture and Subsequent Repair Methods: A Comparison of Two Combined Treatment Pathways

BackgroundDistal biceps brachii tendon rupture is an uncommon injury that is predominantly caused by excessive eccentric force to a flexed elbow.Operative repair is generally preferred to restore function, with a variety of surgical fixation techniques and postoperative rehabilitation protocols currently employed but with no clear consensus regarding the optimal approach.Comparative evidence evaluating surgical techniques remains limited. ObjectiveThe objective of this study is to compare two combined treatment pathways for distal biceps tendon repair using postoperative complications such as rerupture rates to compare postoperative outcomes to complication profiles. MethodsAll patients undergoing distal biceps repair in a single center in Wales, United Kingdom, between 2018 and 2022 were included.Patients were operated on by one of two surgeons.Information was gathered from electronic patient records and radiographic images.Demographics including age, gender, hand dominance, occupation, the mechanism of injury, and surgical intervention were recorded.Clinic letters were reviewed to determine the incidence of postoperative function and complications. ResultsForty-four men were included with a median age of 45 years.All patients reported eccentric contraction as their mechanism of injury.The injury affected the dominant upper limb in all 44 patients (100%).The median time to surgery after imaging was 24 days.In the Surgeon 1 cohort, lateral cutaneous nerve (LCN) numbness was documented in 15 patients (50.0%) and elbow stiffness in six patients (20.0%).In the Surgeon 2 cohort, LCN paresthesia occurred in four patients (28.6%), stiffness in three patients (21.4%), and superficial radial nerve (SRN) paresthesia in two patients (14.3%).One patient required a revision of their biceps tendon repair (2%).All but one patient in each cohort achieved complete functional resolution by three months postoperatively. ConclusionsThe operative management of distal biceps rupture in this unit demonstrates similar postoperative outcomes from both treatment pathways.