Anatomical intramedullary distal biceps tendon fixation. Our first experience

BACKGROUND: Intramedullary fixatiovn in distal biceps tendon repair has been proposed to address specific shortcomings of current fixation techniques. Previous studies described a nonanatomical repair. HYPOTHESIS: The purpose of the present study is to report the short-term outcomes of an anatomic intramedullary fixation. STUDY DESIGN: We evaluated functional and radiographic outcomes up to 6 months of follow-up. METHODS: Patients with an acute distal biceps tendon rupture eligible for surgical repair were invited to take part in the study. Eleven patients were included in the final analysis. All patients were evaluated both clinically and radiographically at 2 weeks, 6 weeks, 3 months, and 6 months. Outcomes were recorded using the visual analog scale score for pain, the Mayo Elbow Performance Score, and Disabilities of the Arm, Shoulder, and Hand scores. The radiographic evaluation comprised X-ray and CT evaluation. RESULTS: There were no failures of fixation in the patient group examined. Elbow mobility was symmetric for all patients from 6 months onward. Supination strength was similar uninjured side at final follow-up. Mean Disabilities of the Arm, Shoulder, and Hand score and Mayo Elbow Performance Score at final follow-up were 0 and 100, respectively. Computed tomography images showed no signs of button migration, cortical thinning due to button pressure or button breakout. The tendon could be followed to the button in all cases. One case of heterotopic ossification was seen. CONCLUSIONS: Anatomical intramedullary fixation of the DBT has excellent functional outcomes at 6 months. The anatomical repair resulted in a restoration of supination strength. This technique allows the anatomical reinsertion of the distal biceps tendon while minimizing the risk of PIN injury. The intraosseous position of the tendon avoids gap formation. No adverse reactions of the button on the bone were seen.