The video illustrates a distal biceps tendon repair using a single-incision anterior approach and flexible reamer. 11,12,26 Boyd and Anderson then devised a 2-incision . BACKGROUND: There are many techniques described to repair acute distal biceps tendon ruptures. Develop interval. rences in outcome at a minimum of one year postoperatively. The distal biceps is usually repaired through a single incision (front of the elbow) or a double incision (front and back of the elbow) technique. This technique is a safe, effective and robust method to reliably achieve anatomic repair, and essentially normal function of the repaired biceps. 6,9 Along with different surgical approaches, numerous methods of reattachment . Surgical Technique for Single and Double-Incision Method ... A 2.4-mm angled and curved guide creates the starting point, and a flexible cannulated reamer (7- or 8-mm) tunnels into the anterior cortex. Single-Incision Technique for Repair of Distal Biceps ... Distal Biceps Repair Through Single Incision Tendonopathies Neurovascular Disorders Arthroplasty Total Elbow Arthroplasty with Triceps-Reflecting Approach, Supine Contractures & Stiffness Arthrodesis Updated: 4/20/2020. develop interval between pronator teres and brachioradialis and palpate radial tuberosity. describe a technique for distal biceps tendon repair using a single-incision approach with intramedullary cortical button fixation. Anatomic Single-Incision Repair of Distal Biceps Tendon ... During the procedure: The primary outcome was the . Distal biceps tendon ruptures are relatively uncommon injuries that occur in only 1.2 of 100,000 people annually and represent 3% of all injuries to the biceps tendon.1, 2 Most individuals who experience distal biceps ruptures are men between the 4th and 5th decade of their lives.2, 3, 4 The injury occurs when the elbow is forcefully extended . Mark and start the incision. Distal Biceps Tendon Repair. In a single-incision exposure, an anterior approach is per-formed through the antecubital fossa. Single-Incision Technique for Repair of Distal Biceps ... In 2-incision re-pairs, the tendon is retrieved through an incision in the 6,9 Along with different surgical approaches, numerous methods of reattachment . When the distal biceps tendon detaches from the radial tuberosity, several surgical techniques have been described to repair the ruptured tendon. A 2.4-mm angled and curved guide creates the starting point, and a flexible cannulated reamer (7- or 8-mm) tunnels into the anterior cortex. 2014; 30(5):561-567. The purpose of this study is to report the results of a single limited-incision technique for repair of acute distal biceps ruptures by use of suture anchors. Mark and start the incision. Crossref, Google Scholar Locate and tag the biceps tendon. The ArthroTunneler device is placed around the ulnar side of the radial tuberosity, and 2 drill holes are spaced approximately 8 to 10 mm apart. Arthroscopy. Patients were followed at three, six, twelve, and twenty-four months postoperatively. 2. No patients required revision surgery, and there was only 1 case of t … When the distal biceps tendon detaches from the radial tuberosity, several surgical techniques have been described to repair the ruptured tendon. Any damaged tissues are removed using specialized instruments. Conclusion: Though many reported techniques for chronic distal biceps tendon repair achieve satisfactory outcomes with limited complications, we present a technique with theoretical advantages of a single incision, use of suture anchors, use of a tibialis anterior allograft and tensioning after attachment of the graft to the radial tuberosity. The tendon stump is identified and a baseball type stitch is placed. This video demonstrates the use of a button technique. 3. Distal biceps tendon ruptures are uncommon injuries responsible for only 3% of all injuries to the biceps tendon. Single-incision repair with the ArthroTunneler is a safe and effective technique that provides the anatomic restoration of a 2-incision approach with the decreased complication profile of a . develop interval between pronator teres and brachioradialis and palpate radial tuberosity. It helps in bending your elbow as well as in rotational movements of your forearm. The patient is positioned supine, with the arm resting on a hand table. The combination of the cortical button fixation coupled with an interference screw creates a strong, anatomic repair. Distal biceps tendon repair using the BicepsButton™ and tension-slide technique allows the surgeon to tension and repair the biceps tendon through a single anterior incision. 11,26 However, this technique resulted in a high incidence of posterior interosseous and radial nerve complications secondary to difficult exposure for suture tying. 3. Surgical repair can be performed by a single- or double-incision . This technique is a safe, effective and robust method to reliably achieve anatomic repair, and essentially normal function of the repaired biceps. 4,37 Traditionally, the surgery is performed through either a single anterior incision or a double-incision approach. You will be administered general anesthesia. A small incision is made at the elbow, and the torn or ruptured end of the biceps located. Single-incision anterior approach for repair of the ruptured distal biceps tendon of the right forearm using the ArthroTunneler with the patient in the supine position and arm on the hand table. David Tuckman, M.D.This repair technique allows repair through a very small incision and increases repair strength by 90%, allowing early range of motion.htt. A small incision is made at the elbow, and the torn or ruptured end of the biceps located. How is the Distal Biceps Repaired? tag tendon with heavy suture. Single incision biceps repair with suture anchor fixation using our hemi-Krackow stitch provided a strong repair allowing easy tensioning of the biceps tendon to bone and showed satisfactory functional outcomes at early follow-up. A cadaveric analysis of tunnel position created using flexible versus rigid instrumentation in a single-incision distal biceps tendon repair. HYPOTHESIS: Dual fixation of a distal biceps rupture will allow for early return to function. Develop interval. In this Technical Note and accompanying video, we describe . Step 1 single-incision technique surgical exposure and preparation of the tendon: Through a single anterior incision, identify the tendon and debride the distal degenerated portion. 1. A single-incision technique for distal biceps repair is highlighted. Although a number of surgical techniques exist, repair of the distal biceps through a single incision is gaining popularity. Introduction: Distal biceps tendon ruptures can be repaired with either a single or a double-incision technique. 2. Distal Biceps Repair. With the patient in the supine position and the arm out on an arm board, an incision is created just distal to the elbow flexion crease over the tuberosity. Distal biceps tendon repair using the BicepsButton™ and tension-slide technique allows the surgeon to tension and repair the biceps tendon through a single anterior incision. The distal biceps is the area where the biceps attaches to the forearm bone in the elbow. The authors report the following potential conflict of interest or source of The biceps is a large muscle located in the front of your upper arm and runs from the shoulder to the elbow joint. mark and make a 2cm incision distal to elbow crease over biceps attachment. Fabricate a posterior elbow splint, which blocks extension at 30 . Tears of the distal biceps tendon occur primarily in middle-aged males. The tendon stump is identified and a baseball type stitch is placed. This may be due in part to patient preference and emerging technologies such as cortical button fixation, suture anchors, and intraosseous screws. 1. Biceps tendon repair is a surgical procedure to restore a biceps tendon that has been torn or ruptured by severe trauma or injury. The authors present a simplified method for the repair of distal biceps tendon ruptures through a single anterior incision. 0; Chronic Distal Biceps Repair, Single Incision, Allograft, Unicortical Button . When compared with 2-incision repair techniques, single-incision repairs historically may not have restored the anatomic footprint of the distal biceps. The video illustrates a distal biceps tendon repair using a single-incision anterior approach and flexible reamer. Surgical repair of distal biceps tendon ruptures can be performed by either a single- or double-incision repair technique. Step 1 Single-Incision Technique Surgical Exposure and Preparation of the Tendon: Through a single anterior incision, identify the tendon and debride the distal degenerated portion. Late Distal Biceps Repair; Anatomic Restoration of the Biceps Brachii Insertion Through a Single Anterior Incision; The Extended Flexor Carpi Radialis Approach: A New Perspective for the Distal Radius Fracture; Anterior Approach for Operative Fixation of Coronoid Fractures in Complex Elbow Instability 10.1016/j.arthro.2014.01.013. For most of these cases, unless the patient is elderly or infirm, conservative management should be avoided and the injury should be treated with a surgical procedure to reattach the bicep tendon to the radial tuberosity. Patients were followed at three, six, twelve, and twenty-four months postoperatively. mark and make a 2cm incision distal to elbow crease over biceps attachment. When compared with 2-incision repair techniques, single-incision repairs historically may not have restored the anatomic footprint of the distal biceps. Step 2 Single-Incision Technique Preparation of the Radius: Expose the bicipital tuberosity and . 4,37 Traditionally, the surgery is performed through either a single anterior incision or a double-incision approach. Historically, a single-incision was first used. We also report our results with 27 cases with > 30 month followup. The combination of the cortical button fixation coupled with an interference screw creates a strong, anatomic repair. There are several techniques described for reattaching the avulsed distal biceps through a single volar incision. This may be due in part to patient preference and emerging technologies such as cortical button fixation, suture anchors, and intraosseous screws. Retrospective series of 70 consecutive distal biceps tendon repairs, at a mean follow-up of 45.6 months after surgery, using a standardised single implant, single-incision technique, and post-operative rehabilitation programme. A single-incision technique for distal biceps repair is highlighted. The patient is positioned supine, with the arm resting on a hand table. DISTAL BICEP TENDON REPAIR SINGLE INCISION ENDO-BUTTON TECHNIQUE REHABILITATION PROTOCOL Week 1 - 2 Remove surgical dressing and apply edema control (Kerlix or ace bandage). With the patient in the supine position and the arm out on an arm board, an incision is created just distal to the elbow flexion crease over the tuberosity. Methods: Patients with an acute distal biceps rupture were randomized to either a single-incision repair with use of two suture anchors (n = 47) or a double-incision repair with use of transosseous drill holes (n = 44). During the procedure: You will be administered general anesthesia. The combination of the cortical button fixation coupled with an interference screw creates a strong, anatomic repair. Step 2 single-incision technique preparation of the radius: Expose the bicipital tuberosity and . reported a 23.9% complication rate for the single . The authors' objective is to report the results of a single-incision technique using a combination of a soft tissue button and biotenodesis interference screw with accelerated rehabilitation. The homogeneous groups are prospectively randomized. The distal biceps is usually repaired through a single incision (front of the elbow) or a double incision (front and back of the elbow) technique. 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