Double incision repair technique with immediate mobilization for acute distal biceps tendon ruptures provides good results after 2 years in active patients

Introduction: Surgical treatment of distal biceps tendon ruptures is recommended in an active population to avoid loss of strength, especially in supination and flexion. Hypothesis: A double incision repair technique with immediate postoperative mobilization for acute distal biceps tendon ruptures is safe and provides good results after 2 years in active patients. Material and methods: Seventy-four men (47 +/- 7 years) with acute tears of the distal biceps tendon tears were included in this retrospective single-center study. All patients were operated using the double-incision repair technique described by Morrey. The tendon was inserted with transosseous sutures into the biceps tuberosity. Patients were allowed to perform immediate postoperative active mobilization. A minimum follow-up of two years was required including clinical and radiological evaluation. Results: Sixteen patients were lost to follow up leaving 58 (78%) patients for analysis with a mean follow-up of 53 +/- 19 months. At final follow-up, the mean evaluation for pain on the VAS scale was 0.22 +/- 0.7. Mean range of motion results included extension -1 degrees +/- 2 degrees, flexion 138 degrees +/- 6 degrees, pronation 72 degrees +/- 16 degrees and supination 81 degrees +/- 10 degrees. The strength ratio in flexion was 94 +/- 8% and in supination 90.5 +/- 12% compared to the contralateral limb. Subjective elbow value and DASH score were respectively 94 +/- 6% and 7.5 +/- 9%. All patients were satisfied or very satisfied and all except one returned to their previous sport. We noticed 2 heterotopic ossifications and one patient needed a reoperation for a radioulnar synostosis. Neither re-rupture nor nerve injury were observed. Discussion: A double incision technique for distal biceps tendon repair is a minimally invasive procedure with reliable results. Morrey's modification of the initial procedure associated with early mobilization is associated with a low rate of complications and limited the occurrence of synostosis or ossifications. Level of evidence: IV, case series, with no comparison group. (C) 2018 Elsevier Masson SAS. All rights reserved.