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Outcomes and Complications After Repair of Complete Distal Biceps Tendon Rupture with the Cortical Button Technique

Numerous surgical techniques have been described for the repair of complete distal biceps tendon ruptures. However, the outcome of repair with cortical button fixation has not been extensively evaluated. The hypothesis of the present study was that elbow strength and range of motion would be less th...

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Autores principales: Huynh, Tiffany, Leiter, Jeff, MacDonald, Peter B., Dubberley, James, Stranges, Gregory, Old, Jason, Marsh, Jonathon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766377/
https://www.ncbi.nlm.nih.gov/pubmed/31592499
http://dx.doi.org/10.2106/JBJS.OA.19.00013
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author Huynh, Tiffany
Leiter, Jeff
MacDonald, Peter B.
Dubberley, James
Stranges, Gregory
Old, Jason
Marsh, Jonathon
author_facet Huynh, Tiffany
Leiter, Jeff
MacDonald, Peter B.
Dubberley, James
Stranges, Gregory
Old, Jason
Marsh, Jonathon
author_sort Huynh, Tiffany
collection PubMed
description Numerous surgical techniques have been described for the repair of complete distal biceps tendon ruptures. However, the outcome of repair with cortical button fixation has not been extensively evaluated. The hypothesis of the present study was that elbow strength and range of motion would be less than normal after repair but that ongoing disability would be minimal as measured with use of the Disabilities of the Arm, Shoulder and Hand (DASH) score. METHODS: We performed a retrospective cohort study of patients with complete distal biceps tendon rupture that was repaired with cortical button fixation via a 1-incision anterior approach. Outcome was assessed on the basis of elbow range-of-motion and strength measurements, DASH scores, and radiographs of the operatively treated elbow. Descriptive statistics were generated for patient demographics and outcome variables. Strength was assessed with limb-symmetry index, and range of motion was evaluated with paired t tests. RESULTS: Sixty male patients consented to this study. The average age at the time of follow-up was 49.6 ± 7.8 years, and the average time from injury to follow-up was 3.7 ± 1.7 years. The mechanism of injury included lifting heavy objects (62%) and sporting activities (25%). Elbow flexion and supination range of motion were not different between the operatively treated and contralateral arms. The operatively treated elbow demonstrated decreased flexion strength (96% of that on the contralateral side) and supination strength (91% of that on the contralateral side). The findings did not change when controlling for hand dominance. The mean DASH score was 7.9 ± 11.4, which is not significantly different from the normative value for the general population. Postoperative complications included heterotopic ossification (Brooker class I [29 patients] or II [5 patients]), neurapraxia (7 patients), and rerupture (3 patients). CONCLUSIONS: The repair of complete distal biceps tendon ruptures with cortical button fixation was associated with decreased strength in elbow flexion and forearm supination compared with the contralateral arm, although the differences were small and likely were not clinically important. The complication rate was relatively high; however, most complications were minor and were associated with minimal disability, as reflected by the DASH scores. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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spelling pubmed-67663772019-10-07 Outcomes and Complications After Repair of Complete Distal Biceps Tendon Rupture with the Cortical Button Technique Huynh, Tiffany Leiter, Jeff MacDonald, Peter B. Dubberley, James Stranges, Gregory Old, Jason Marsh, Jonathon JB JS Open Access Scientific Articles Numerous surgical techniques have been described for the repair of complete distal biceps tendon ruptures. However, the outcome of repair with cortical button fixation has not been extensively evaluated. The hypothesis of the present study was that elbow strength and range of motion would be less than normal after repair but that ongoing disability would be minimal as measured with use of the Disabilities of the Arm, Shoulder and Hand (DASH) score. METHODS: We performed a retrospective cohort study of patients with complete distal biceps tendon rupture that was repaired with cortical button fixation via a 1-incision anterior approach. Outcome was assessed on the basis of elbow range-of-motion and strength measurements, DASH scores, and radiographs of the operatively treated elbow. Descriptive statistics were generated for patient demographics and outcome variables. Strength was assessed with limb-symmetry index, and range of motion was evaluated with paired t tests. RESULTS: Sixty male patients consented to this study. The average age at the time of follow-up was 49.6 ± 7.8 years, and the average time from injury to follow-up was 3.7 ± 1.7 years. The mechanism of injury included lifting heavy objects (62%) and sporting activities (25%). Elbow flexion and supination range of motion were not different between the operatively treated and contralateral arms. The operatively treated elbow demonstrated decreased flexion strength (96% of that on the contralateral side) and supination strength (91% of that on the contralateral side). The findings did not change when controlling for hand dominance. The mean DASH score was 7.9 ± 11.4, which is not significantly different from the normative value for the general population. Postoperative complications included heterotopic ossification (Brooker class I [29 patients] or II [5 patients]), neurapraxia (7 patients), and rerupture (3 patients). CONCLUSIONS: The repair of complete distal biceps tendon ruptures with cortical button fixation was associated with decreased strength in elbow flexion and forearm supination compared with the contralateral arm, although the differences were small and likely were not clinically important. The complication rate was relatively high; however, most complications were minor and were associated with minimal disability, as reflected by the DASH scores. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Wolters Kluwer 2019-08-27 /pmc/articles/PMC6766377/ /pubmed/31592499 http://dx.doi.org/10.2106/JBJS.OA.19.00013 Text en Copyright © 2019 The Authors. Published by The Journal of Bone and Joint Surgery, Incorporated. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Scientific Articles
Huynh, Tiffany
Leiter, Jeff
MacDonald, Peter B.
Dubberley, James
Stranges, Gregory
Old, Jason
Marsh, Jonathon
Outcomes and Complications After Repair of Complete Distal Biceps Tendon Rupture with the Cortical Button Technique
title Outcomes and Complications After Repair of Complete Distal Biceps Tendon Rupture with the Cortical Button Technique
title_full Outcomes and Complications After Repair of Complete Distal Biceps Tendon Rupture with the Cortical Button Technique
title_fullStr Outcomes and Complications After Repair of Complete Distal Biceps Tendon Rupture with the Cortical Button Technique
title_full_unstemmed Outcomes and Complications After Repair of Complete Distal Biceps Tendon Rupture with the Cortical Button Technique
title_short Outcomes and Complications After Repair of Complete Distal Biceps Tendon Rupture with the Cortical Button Technique
title_sort outcomes and complications after repair of complete distal biceps tendon rupture with the cortical button technique
topic Scientific Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766377/
https://www.ncbi.nlm.nih.gov/pubmed/31592499
http://dx.doi.org/10.2106/JBJS.OA.19.00013
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