Endobutton-Assisted Repair of Complete Distal Biceps Tendon Rupture in a Woman

Abstract not available. Introduction provided instead.

Avulsion of the distal biceps brachii tendon from the radial tuberosity is a relatively
rare clinical entity. The injury, which accounts for approximately 3% of all biceps tendon injuries, most commonly occurs in the dominant elbow of men who smoke and are in their fourth decade of life.¹ This injury is extremely rare in women. There are several reports of women sustaining partial ruptures of the distal biceps tendon.^2,3 Reports of complete rupture are even less common, and most involve
elderly patients.^1,4-6

Typically, an unanticipated eccentric load applied to the flexed arm immediately produces a sharp pain in the antecubital region. Subsequent clinical findings include swelling and ecchymosis, palpation of a tendon defect or tendon stump, and weakness in supination and elbow flexion.

Although there are reports of successful nonsurgical management and nonanatomical repair, most authors recommend acute anatomical repair to restore flexion and supination strength. Current support for anatomical reattachment of distal biceps ruptures stems from documented deficits in flexion and supination strength after nonoperative and nonanatomical repair. Conservative treatment has
been shown to result in a 30% decrease in flexion strength and a 40% decrease
in supination strength.⁷

We present the case of a woman with a traumatic distal biceps tendon rupture (but no preexisting risk factors) treated surgically with a single-incision Endobutton technique.