Fixation of acute proximal and distal biceps tendon ruptures can be facilitated by the use of suture anchors. Originally designed for open Bankart procedures, suture anchors provide adequate fixation for soft tissue healing, limit the extent of dissection, reduce the incidence of frozen shoulder and damage to neurovascular structures and allow early postoperative rehabilitation. Four consecutive patients were successfully treated by this method with a minimum follow-up period of 1 year.
"Strength and endurance results seem to be equally good with these techniques (5– 6% loss of flexion strength, 24–30% loss of flexion endurance, 14–15% loss of supination strength and 7–20% loss of supination endurance) (Baker and Bierwagen 1985, Catonné et al. 1995). Complications like postoperative radial nerve palsy (Sleebom and Regort 1991, Bak et al. 1992) and motion-limiting soft-tissue calcification (Failla et al. 1990, Karunakar et al. 1999) have led to technical modifications with use of bone anchors (Verhaven et al. 1993, Le Huec et al. 1996) and limited dorsal exposure (Failla et al. 1990, D'Arco et al. 1998). Comparisons of earlier "
[Show abstract][Hide abstract] ABSTRACT: We operated on 9 patients for distal biceps tendon rupture using the Boyd-Anderson technique. All patients were re-examined after at least 1 year using a questionnaire, radiographs, motion measurements and isokinetic testing. 2 patients had temporary radial nerve dysfunction and 7 patients had diminished forearm rotation. Elbow flexion strength was reduced by median 13% and supination strength by 19%. We think the Boyd-Anderson technique can be recommended, but slightly reduced strength and forearm rotation must be expected.
[Show abstract][Hide abstract] ABSTRACT: Clinical reports suggest that suture anchors can simplify repair of distal biceps tendon avulsions. In this study, fixation strengths of Mitek and Statak suture anchors were compared with strength of reattachment using transosseous suture tunnels in eight cadaveric radii. Cyclic loading and load-to-failure testing were performed: No specimen failed during testing to 50 N for 3600 cycles: however, four of the Mitek anchors and one of the Statak anchors protruded out of the medullary canal. The mean load to failure of the Mitek suture anchor complexes was 220 +/- 54 N, that of the Statak suture anchor complexes was 187 +/- 64 N, and that of the transosseous sutures was 307 +/- 142 N. There was no significant difference in the failure load or mechanism of failure between the Statak and Mitek anchors. Transosseous sutures failed at significantly greater loads on static testing than the suture anchors. Cyclic loading results suggest that the bony fixation achieved using these three techniques should be sufficient to allow immediate passive mobilization of the elbow after surgery. Protrusion of the suture anchors out of the tuberosity during cyclic loading is a concern because of potential development of a gap at the repair site and interference with forearm rotation.
The American Journal of Sports Medicine 05/1998; 26(3):428-32. · 4.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We retrospectively evaluated six cases of distal biceps tendon rupture that were treated by a two-incision operative repair using suture anchor attachment to the radial tuberosity for clinical outcome and strength testing. All patients had repair performed by the same surgeon. The average age of the patients, all male, was 43 years (range, 32-57 years). Average time from injury to operative repair was 22 days (range, 9-54 days). Follow-up time averaged 24 months after definitive treatment (range, 11-46 months). At follow-up no patient had limitation of activity and all patients were able to return to their previous employment, although three noted some minor antecubital fossa discomfort. No patient developed a synostosis. Cybex (Medway, Mass.) isokinetic testing revealed elbow flexion strength return for peak torque, total work, and average power, of 107%, 103%, and 110% of the uninjured arm, respectively. Elbow flexion endurance was 2% less in the injured arm. Forearm supination strength measured by peak torque, total work, and average power, was 97%, 85%, and 88% of the uninjured arm, respectively. Forearm supination endurance was 10% less in the injured arm. Our results using suture anchor repair are similar to those previously reported in the literature from bone tunnel repair. Based on our data, we believe that a two-incision repair with suture anchor attachment is a safe and effective method for treatment of distal biceps tendon ruptures.
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