Distal Biceps Tendon Rupture

Question 1

Where do distal biceps tendon ruptures originate from

Answer 1

1. The distal biceps insertion at the radial tuberosity

Question 2

What is the presentation of a distal biceps tendon rupture?

Answer 2

1. Sudden pain at anterior elbow
2. History of lifting (force exerted on flexed elbow)
3. Pain decreases over the course of the first day

Question 3

Which bicep tendon rupture causes more weakness? Distal or Proximal?

Answer 3

1. Proximal

Question 4

What will be found on the PE?

Answer 4

1. Palpable defect antecubital area
   *wont feel the tendon or wont be as wide
2. Bruising
3. Muscle retraction up into arm with flexion of elbow

Question 5

What are the diagnostic tests?

Answer 5

1. Radiographs
   *normal
   *avulsion fracture may be present
2. MRI confirms diagnosis

Question 6

What is the treatment?

Answer 6

1. Surgical repair #1
   Non-surgical treatment:
   *reserved for the elderly, poor surgical candidates, non dominant arm with delayed presentations

Question 7

What are the adverse outcomes?

Answer 7

1. Continued weakness
2. Radial nerve injury
3. Infection
4. Chronic pain
5. Ectopic ossification (bone growth where you don’t want it)
   ***refer all cases to ortho