Biomechanical evaluation of 4 techniques of distal biceps. Repair of distal biceps ruptures in active, healthy patients has a high satisfaction rate regardless of technique or approach. Endobutton technique for repair for acute distal biceps tendon rupture. The discharge instructions after distal biceps tendon repair. In this retrospective study, its been described the occurrence of the most frequent adverse events and the clinical outcomes of patients undergoing surgical repair of distal biceps tendon rupture with the modified morreys doubleincision approach, to determine better indications for. Specific changes in the program will be made by the physician as appropriate for an individual patient.
Distal biceps repair with endobutton rehabilitation protocol week 1 sling for comfort. The biceps has two muscle bellies known as the short and long head of biceps. Distal biceps tendon repair rehabilitation protocol. It is by no means intended to be a substitute for ones clinical decision making. Distal biceps tendon protocol brigham and womens hospital. At the shoulder there are two tendon attachements, where as at the elbow there is one tendon distal attaching to the radius bone of the forearm.
On february 8, 2012 appellant underwent left distal biceps repair under the care of dr. Distal biceps tendon tear is a condition in which the distal biceps tendon i. The tendon at the elbow is also called the distal biceps tendon. In some cases, rupture of the biceps tendon can occur. Uva hand center therapy 415 ray c hunt drive, suite 3200 charlottesville, va 22903 434982hand 4263 biceps tendon repair hep stage 4 week 8 now that you are 8 weeks post operative, your tendon repair is strong enough to allow you to begin gentle rom out. Of all biceps injuries, only 3% occur as a rupture or avulsion at the distal insertion.
Anthony romeo, md, chicago, il discusses an anterior, singleincision approach to distal biceps repair using a bicepsbutton and tension slide technique. Distal bicep tendon repair rehabilitation protocol the intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course for a patient that has undergone a distal biceps tendon repair. Distal biceps tendon repair rehabilitation protocol the following protocol should be used as a guideline for rehabilitation progression, but may need to be altered pending the nature and extent of the surgical procedure, healing restraints or patient tolerance. Mcl, lcl, and posterior oblique ligament illiotibial band tenodesis patellar tendon repair vmo advancement joint capsule closure hand and wrist collateral. You will be given a prescription for pain medication at your preoperative appointment. I am doing a distal biceps repair alone with no other procedures. Most patients will require narcotic pain medications for short. Distal biceps tendon ruptures are thought to be secondary to an acute forceful eccentric load on a degenerative tendon.
Rupture of the distal biceps tendon is a relatively rare injury that may. Chronic distal biceps repair with an achilles allograft. If you have any questions regarding the progress of the patient, the physician should be contacted. If the tendon has completely severed, then surgery may be the patients only option. Distal biceps tendon injuries typically occur in the dominant arm of men in their fourth decade of life. Uw health s sports medicine sports rehabilitation physical therapists and athletic trainers in madison, wisconsin, help injured athletes return to health and return to sport.
Chronic distal biceps repair, single incision, allograft, unicortical button. Rehabilitation guidelines for distal biceps tendon repair the intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation. Patients with a distal biceps rupture will have asym. Romeo explains how the tension slide technique reliably draws the tendon into the radius and the addition of a. Revision surgery or cases involving allograft procedures may undergo modifications to the below guideline. Distal biceps tendon repair protocol this rehabilitation protocol has been developed for the patient following a tenodesis reattachment of the long head of the biceps tendon surgery. Week 23 initiate scar management patient is placed in a hinged splint with a dynamic flexion component. This should be filled and ready for use when you return home from the hospitalsurgery center. Return to throwing softball rotator cuff repair large to massive. Andrew green, md associate professor of orthopaedic. The intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation. It bends flexes the elbow joint and rotates the forearm to a palm up position. Rehabilitation guidelines for distal bicep tendon repair. Repair of the biceps tendon end of tendon trimmed sutures placed figure 2.
Wear splint and dressings until your visit with md one week after surgery. Outcomes and complications after repair of complete distal. Distal biceps tendon repair using a double tension slide. To regain tendon length and avoid flexion contractures, reconstruction with graft augmentation has been proposed as an alternative for cases not amenable to primary repair. Distal biceps tendon ruptures are uncommon injuries responsible for only 3% of all injuries to the biceps tendon. We performed a retrospective cohort study of patients with complete distal biceps tendon rupture that was repaired with cortical button fixation via a 1incision anterior approach. The elbow is a complex system of three joints formed from three bones. The biceps tendon at the elbow region is the distal biceps tendon. Current repair of a distal biceps tendon rupture has reverted to the single incision technique.
Rehabilitation guidelines distal bicep tendon repair note. Lateral epicondylitis repair biceps tendon reattachment knee aclpcl repair reconstruction aclpcl patellar bonetendonbone grafts doubletunnel acl reconstruction extracapsular repair. Pdf failure strengths in distal biceps tendon repair. We also observed that the distal biceps tendon predictably heals to cortical bone, suggesting that the creation of a bone trough in the proximal radius may not be necessary. Anatomic singleincision repair of distal biceps tendon ruptures. Multiple nerve injuries following repair of a distal. Pdf surgical management of acute distal biceps tendon ruptures. Complications of distal biceps repair musculoskeletal key. Pdf distal biceps brachii tendon ruptures are relatively uncommon. After surgery, you will require rehabilitation and time to heal. Medications local pain medications were used at the time of surgery. Distal biceps tendon ruptures are treated operatively in active healthy individuals. Distal bicep tendon repair rehabilitation protocol.
Andrew green, md associate professor of orthopaedic surgery chief of shoulder and elbow surgery warren alpert medical school, brown university. The elbow joint is made up of the upper arm bone called the humerus and two forearm bones called the radius and the ulna. Patient will be fitted with a hinged, limited rom brace lrom preoperatively. The biceps muscle lies on the front of the upper arm and has two heads. These two codes are very similar to each other and the few wordings can change the whole scenario. Please follow the protocol along with the instructions listed on the patients referral. The total complication rate after repair of the distal biceps tendon is 15% to 35% and is independent of approach. Please try to adhere to the below instructions to help assure the best result. The biotenodesis screw and endobutton technique for repair for. Discharge instructions after distal biceps tendon repair. Rehabilitation guidelines for distal biceps tendon repair. Achilles tendon repair and rehab pdf anterior cruciate ligament more about uw health sports rehabilitation acl rehabilitation. Distal biceps tendon repair rehabilitation protocol michael b.
Distal biceps tendon repair rehab protocol 1 rehabilitation guidelines distal bicep tendon repair note. The biceps muscle has a tendon that crosses the elbow and attaches to the radius in the forearm. Distal bicep tendon repair accelerated rehabilitation protocol the intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course for a patient that has undergone a distal biceps tendon repair. In cases of chronic distal biceps ruptures, the combination of muscle atrophy, distal tendon retraction, and fibrosis makes primary anatomic reattachment of the tendon particularly challenging. This protocol will vary in length and aggressiveness depending on factors such. 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. This protocol was developed for patients who have had a primary repair of the. Distal biceps tendon repair using the bicepsbutton technique 06. Distal biceps repair orthopedic coding ask an expert. The biceps tendon that attaches to the shoulder is the proximal biceps tendon. The pdf of the article you requested follows this cover page. A variety of techniques have been described for distal biceps tendon reattachment, including transosseous.
Treatment consists of either single or doubleincision techniques. Elbow distal biceps tendon repair twin cities orthopedics. Rehabilitation guidelines distal bicep tendon repair. Distal biceps tendon repair foundation for orthopaedic. The goal of the rehabilitation is to gradually regain motion in the elbow joint and. The combination of the cortical button fixation coupled with an interference screw creates a strong, anatomic repair. Disclosures i have no disclosures relevant to this topic. Anatomic singleincision repair of distal biceps tendon. Postoperative complications are rare, but the most common are due to neuropraxia.
Distal biceps tendon rupture occurs more often in middleaged male population, involving the dominant arm. With the patient in the supine position and the arm. If nerve block was administered, this may give you longer relief. These lesions typically occur in a male population aged between the. Distal biceps tendon repair using the bicepsbutton and tensionslide technique allows the surgeon to tension and repair the biceps tendon through a single anterior incision. Biomechanical evaluation of 4 techniques of distal biceps brachii tendon repair article in the american journal of sports medicine 352. Distal triceps tendon repair university orthopedics.
Additional restrictions or modifications will be listed in the last paragraph of the operative report and the therapy instructions. Look out for the exact documentation of the report. This report described rupture and subsequent repair of the medial head of a bifurcated distal biceps tendon, which had two completely unfused, distinct tendon units and musculotendinous junctions. It is not intended to be a substitute for ones clinical decision making.
The biceps originates from the front of the shoulder blade attaching here via the short and long head of biceps and inserts into the forearm via the distal biceps tendon figure 1. A january 19, 2012 magnetic resonance imaging mri scan revealed a complete tear of the biceps tendon ruptured distally and mild enlargement of the ulnar nerve with cubital tunnel. Surgical repair is the most favored treatment for a rupture of the distal biceps tendon. Rehabilitation guidelines for distal bicep tendon repair uw health. Left without surgical repair, however, the injured arm will have a 30% to 40% decrease in strength, mainly in twisting the forearm supination. Use ice on the elbow intermittently over the first 48 hours after surgery. We present the case of patient who sustained multiple nerve injuries following distal biceps repair. Rehabilitation guidelines after surgery, sports medicine.
Pdf distal biceps tendon rupture repair using an endobutton. Rupture of the proximal portion of the biceps tendon occurs often when there is a degenerative change within the tendon leading to structure failure. Distal bicep tendonitis is inflammation around the tendon that can develop over time or with injury. Rehabilitation protocols ohio state sports medicine.
1022 1127 310 738 126 690 99 475 265 128 355 748 1136 6 716 720 894 345 102 268 1226 1055 773 1435 684 1201 304 407 1377 227 488 322