Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2020

17.08.2019 | ELBOW

An intact lacertus fibrosus improves strength after reinsertion of the distal biceps tendon

verfasst von: Kaare Sourin Midtgaard, Hanna Björnsson Hallgren, Karin Frånlund, Fredrik Gidmark, Endre Søreide, Torsten Johansson, Lars Adolfsson

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 7/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The importance of an intact lacertus fibrosus in distal biceps tendon injury is uncertain. This study aimed to assess long-term outcome following distal biceps tendon repair with focus on the significance of the lacertus fibrosus.

Methods

Thirty-six patients surgically treated for primary distal biceps tendon rupture were identified. Medical records were reviewed for patient demographics in addition to surgery-related data. All patients underwent a targeted clinical examination to assess elbow function and they completed a patient reported questionnaire. Radiographs were obtained at time of follow-up and evaluated for the presence of osteoarthritis (OA) and heterotopic ossification (HO).

Results

All patients were male. Median age at injury was 48 years (34–69) and median time of follow-up of was 71 months (23–165). All patients presented functional range of motion in the elbow. Median flexion strength was 76 Nm (45–135) (median 99% of uninjured side; range 66–128) with intact lacertus fibrosus and 70 Nm (43–124) (88%, 62–114) with torn lacertus fibrosus. Median supination strength was 6 Nm (3–11) (86%, range 36–144) with intact lacertus fibrosus and 8 Nm (3–17) (67%, 28–118) with torn lacertus fibrosus. No signs of OA were revealed, but three patients had major HO of which one patient had minor limitations in range of elbow motion.

Conclusion

An intact lacertus fibrosus contributes to elbow strength and should be preserved in distal biceps tendon repair.

Level of evidence

III.
Literatur
1.
Zurück zum Zitat Beaton DE, Wright JG, Katz JN (2005) Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Jt Surg Am 87:1038–1046 Beaton DE, Wright JG, Katz JN (2005) Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Jt Surg Am 87:1038–1046
2.
Zurück zum Zitat Boyd HB, Anderson LD (1961) A method for reinsertion of the distal biceps brachii tendon. J Bone Jt Surg Am 43:1041–1043CrossRef Boyd HB, Anderson LD (1961) A method for reinsertion of the distal biceps brachii tendon. J Bone Jt Surg Am 43:1041–1043CrossRef
3.
Zurück zum Zitat Broberg MA, Morrey BF (1986) Results of delayed excision of the radial head after fracture. J Bone Jt Surg Am 68:669–674CrossRef Broberg MA, Morrey BF (1986) Results of delayed excision of the radial head after fracture. J Bone Jt Surg Am 68:669–674CrossRef
4.
Zurück zum Zitat Broberg MA, Morrey BF (1987) Results of treatment of fracture-dislocations of the elbow. Clin Orthop Relat Res 216:109–119 Broberg MA, Morrey BF (1987) Results of treatment of fracture-dislocations of the elbow. Clin Orthop Relat Res 216:109–119
5.
Zurück zum Zitat Caputo AE, Cusano A, Stannard J, Hamer MJ (2016) Distal biceps repair using the lacertus fibrosus as a local graft. J Shoulder Elbow Surg 25:1189–1194CrossRef Caputo AE, Cusano A, Stannard J, Hamer MJ (2016) Distal biceps repair using the lacertus fibrosus as a local graft. J Shoulder Elbow Surg 25:1189–1194CrossRef
6.
Zurück zum Zitat Cohen SB, Buckley PS, Neuman B, Leland JM, Ciccotti MG, Lazarus M (2016) A functional analysis of distal biceps tendon repair: single-incision Endobutton technique vs. two-incision modified Boyd-Anderson technique. Phys Sportsmed 44:59–62CrossRef Cohen SB, Buckley PS, Neuman B, Leland JM, Ciccotti MG, Lazarus M (2016) A functional analysis of distal biceps tendon repair: single-incision Endobutton technique vs. two-incision modified Boyd-Anderson technique. Phys Sportsmed 44:59–62CrossRef
7.
Zurück zum Zitat Congdon ED, Fish HS (1953) The chief insertion of the bicipital aponeurosis is on the ulna; a study of collagenous bundle patterns of antebrachial fascia and bicipital aponeurosis. Anat Rec 116:395–407CrossRef Congdon ED, Fish HS (1953) The chief insertion of the bicipital aponeurosis is on the ulna; a study of collagenous bundle patterns of antebrachial fascia and bicipital aponeurosis. Anat Rec 116:395–407CrossRef
8.
Zurück zum Zitat Dillon MT, Bollier MJ, King JC (2011) Repair of acute and chronic distal biceps tendon ruptures using the EndoButton. Hand (N Y) 6:39–46CrossRef Dillon MT, Bollier MJ, King JC (2011) Repair of acute and chronic distal biceps tendon ruptures using the EndoButton. Hand (N Y) 6:39–46CrossRef
9.
Zurück zum Zitat Dobbie RP (1941) Avulsion of the lower biceps brachii tendon: analysis of fifty-one previously unreported cases. Am J Surg 51:662–683CrossRef Dobbie RP (1941) Avulsion of the lower biceps brachii tendon: analysis of fifty-one previously unreported cases. Am J Surg 51:662–683CrossRef
10.
Zurück zum Zitat Dunphy TR, Hudson J, Batech M, Acevedo DC, Mirzayan R (2017) Surgical treatment of distal biceps tendon ruptures: an analysis of complications in 784 surgical repairs. Am J Sports Med 45:3020–3029CrossRef Dunphy TR, Hudson J, Batech M, Acevedo DC, Mirzayan R (2017) Surgical treatment of distal biceps tendon ruptures: an analysis of complications in 784 surgical repairs. Am J Sports Med 45:3020–3029CrossRef
11.
Zurück zum Zitat Eames MH, Bain GI, Fogg QA, van Riet RP (2007) Distal biceps tendon anatomy: a cadaveric study. J Bone Jt Surg Am 89:1044–1049 Eames MH, Bain GI, Fogg QA, van Riet RP (2007) Distal biceps tendon anatomy: a cadaveric study. J Bone Jt Surg Am 89:1044–1049
12.
Zurück zum Zitat Failla JM, Amadio PC, Morrey BF, Beckenbaugh RD (1990) Proximal radioulnar synostosis after repair of distal biceps brachii rupture by the two-incision technique. Report of four cases. Clin Orthop Relat Res 253:133–136 Failla JM, Amadio PC, Morrey BF, Beckenbaugh RD (1990) Proximal radioulnar synostosis after repair of distal biceps brachii rupture by the two-incision technique. Report of four cases. Clin Orthop Relat Res 253:133–136
13.
Zurück zum Zitat Freeman CR, McCormick KR, Mahoney D, Baratz M, Lubahn JD (2009) Nonoperative treatment of distal biceps tendon ruptures compared with a historical control group. J Bone Jt Surg Am 91:2329–2334CrossRef Freeman CR, McCormick KR, Mahoney D, Baratz M, Lubahn JD (2009) Nonoperative treatment of distal biceps tendon ruptures compared with a historical control group. J Bone Jt Surg Am 91:2329–2334CrossRef
14.
Zurück zum Zitat Grewal R, Athwal GS, MacDermid JC, Faber KJ, Drosdowech DS, El-Hawary R et al (2012) Single versus double-incision technique for the repair of acute distal biceps tendon ruptures: a randomized clinical trial. J Bone Jt Surg Am 94:1166–1174CrossRef Grewal R, Athwal GS, MacDermid JC, Faber KJ, Drosdowech DS, El-Hawary R et al (2012) Single versus double-incision technique for the repair of acute distal biceps tendon ruptures: a randomized clinical trial. J Bone Jt Surg Am 94:1166–1174CrossRef
15.
Zurück zum Zitat Katzman BM, Caligiuri DA, Klein DM, Gorup JM (1997) Delayed onset of posterior interosseous nerve palsy after distal biceps tendon repair. J Shoulder Elbow Surg 6:393–395CrossRef Katzman BM, Caligiuri DA, Klein DM, Gorup JM (1997) Delayed onset of posterior interosseous nerve palsy after distal biceps tendon repair. J Shoulder Elbow Surg 6:393–395CrossRef
16.
Zurück zum Zitat Kelly MP, Perkinson SG, Ablove RH, Tueting JL (2015) Distal Biceps Tendon Ruptures: An Epidemiological Analysis Using a Large Population Database. Am J Sports Med 43:2012–2017CrossRef Kelly MP, Perkinson SG, Ablove RH, Tueting JL (2015) Distal Biceps Tendon Ruptures: An Epidemiological Analysis Using a Large Population Database. Am J Sports Med 43:2012–2017CrossRef
17.
Zurück zum Zitat Konschake M, Stofferin H, Moriggl B (2017) Ultrasound visualization of an underestimated structure: the bicipital aponeurosis. Surg Radiol Anat 39:1317–1322CrossRef Konschake M, Stofferin H, Moriggl B (2017) Ultrasound visualization of an underestimated structure: the bicipital aponeurosis. Surg Radiol Anat 39:1317–1322CrossRef
18.
Zurück zum Zitat Landa J, Bhandari S, Strauss EJ, Walker PS, Meislin RJ (2009) The effect of repair of the lacertus fibrosus on distal biceps tendon repairs: a biomechanical, functional, and anatomic study. Am J Sports Med 37:120–123CrossRef Landa J, Bhandari S, Strauss EJ, Walker PS, Meislin RJ (2009) The effect of repair of the lacertus fibrosus on distal biceps tendon repairs: a biomechanical, functional, and anatomic study. Am J Sports Med 37:120–123CrossRef
19.
Zurück zum Zitat Meherin JM, Kilgore ES (1960) The treatment of ruptures of the distal biceps brachii tendon. Am J Surg 99:636–640CrossRef Meherin JM, Kilgore ES (1960) The treatment of ruptures of the distal biceps brachii tendon. Am J Surg 99:636–640CrossRef
20.
Zurück zum Zitat Morrey BF, Sanchez-Sotelo J, Morrey ME (2018) Acute biceps tendon ruptures. Morrey's The elbow and its disorders, 5th edn. Elsevier, Philadelphia, pp 602–614 Morrey BF, Sanchez-Sotelo J, Morrey ME (2018) Acute biceps tendon ruptures. Morrey's The elbow and its disorders, 5th edn. Elsevier, Philadelphia, pp 602–614
21.
Zurück zum Zitat Murthi AM, Ramirez MA, Parks BG, Carpenter SR (2017) Lacertus fibrosus versus achilles allograft reconstruction for distal biceps tears: a biomechanical study. Am J Sports Med 45:3340–3344CrossRef Murthi AM, Ramirez MA, Parks BG, Carpenter SR (2017) Lacertus fibrosus versus achilles allograft reconstruction for distal biceps tears: a biomechanical study. Am J Sports Med 45:3340–3344CrossRef
22.
Zurück zum Zitat Nesterenko S, Domire ZJ, Morrey BF, Sanchez-Sotelo J (2010) Elbow strength and endurance in patients with a ruptured distal biceps tendon. J Shoulder Elbow Surg 19:184–189CrossRef Nesterenko S, Domire ZJ, Morrey BF, Sanchez-Sotelo J (2010) Elbow strength and endurance in patients with a ruptured distal biceps tendon. J Shoulder Elbow Surg 19:184–189CrossRef
23.
Zurück zum Zitat Ruch DS, Watters TS, Wartinbee DA, Richard MJ, Leversedge FJ, Mithani SK (2014) Anatomic findings and complications after surgical treatment of chronic, partial distal biceps tendon tears: a case cohort comparison study. J Hand Surg Am 39:1572–1577CrossRef Ruch DS, Watters TS, Wartinbee DA, Richard MJ, Leversedge FJ, Mithani SK (2014) Anatomic findings and complications after surgical treatment of chronic, partial distal biceps tendon tears: a case cohort comparison study. J Hand Surg Am 39:1572–1577CrossRef
24.
Zurück zum Zitat Safran MR, Graham SM (2002) Distal biceps tendon ruptures: incidence, demographics, and the effect of smoking. Clin Orthop Relat Res 404:275–283CrossRef Safran MR, Graham SM (2002) Distal biceps tendon ruptures: incidence, demographics, and the effect of smoking. Clin Orthop Relat Res 404:275–283CrossRef
25.
Zurück zum Zitat Shields E, Olsen JR, Williams RB, Rouse L, Maloney M, Voloshin I (2015) Distal biceps brachii tendon repairs: a single-incision technique using a cortical button with interference screw versus a double-incision technique using suture fixation through bone tunnels. Am J Sports Med 43:1072–1076CrossRef Shields E, Olsen JR, Williams RB, Rouse L, Maloney M, Voloshin I (2015) Distal biceps brachii tendon repairs: a single-incision technique using a cortical button with interference screw versus a double-incision technique using suture fixation through bone tunnels. Am J Sports Med 43:1072–1076CrossRef
26.
Zurück zum Zitat Stoll LE, Huang JI (2016) Surgical treatment of distal biceps ruptures. Orthop Clin North Am 47:189–205CrossRef Stoll LE, Huang JI (2016) Surgical treatment of distal biceps ruptures. Orthop Clin North Am 47:189–205CrossRef
27.
Zurück zum Zitat Suda AJ, Prajitno J, Grutzner PA, Tinelli M (2017) Good isometric and isokinetic power restoration after distal biceps tendon repair with anchors. Arch Orthop Trauma Surg 137:939–944CrossRef Suda AJ, Prajitno J, Grutzner PA, Tinelli M (2017) Good isometric and isokinetic power restoration after distal biceps tendon repair with anchors. Arch Orthop Trauma Surg 137:939–944CrossRef
28.
Zurück zum Zitat Swiggett R, Ruby LK (1986) Median nerve compression neuropathy by the lacertus fibrosus: report of three cases. J Hand Surg Am 11:700–703CrossRef Swiggett R, Ruby LK (1986) Median nerve compression neuropathy by the lacertus fibrosus: report of three cases. J Hand Surg Am 11:700–703CrossRef
29.
Zurück zum Zitat Watson JN, Moretti VM, Schwindel L, Hutchinson MR (2014) Repair techniques for acute distal biceps tendon ruptures: a systematic review. J Bone Jt Surg Am 96:2086–2090CrossRef Watson JN, Moretti VM, Schwindel L, Hutchinson MR (2014) Repair techniques for acute distal biceps tendon ruptures: a systematic review. J Bone Jt Surg Am 96:2086–2090CrossRef
Metadaten
Titel
An intact lacertus fibrosus improves strength after reinsertion of the distal biceps tendon
verfasst von
Kaare Sourin Midtgaard
Hanna Björnsson Hallgren
Karin Frånlund
Fredrik Gidmark
Endre Søreide
Torsten Johansson
Lars Adolfsson
Publikationsdatum
17.08.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 7/2020
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-019-05673-2

Weitere Artikel der Ausgabe 7/2020

Knee Surgery, Sports Traumatology, Arthroscopy 7/2020 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.