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Distal Biceps Brachii Injury

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The Elbow

Abstract

Distal biceps ruptures occur most commonly in middle-aged males and result from an eccentric extension load that is applied to the elbow. The injury typically presents with pain and a tearing sensation in the antecubital fossa with resultant weakness in flexion and supination strength. The biceps squeeze and hook tests are specific maneuvers by which to diagnose distal biceps ruptures on physical examination. Magnetic resonance imaging (MRI) or ultrasound is helpful to distinguish between partial and complete tears.

Nonoperative management is reserved for elderly, low-demand patients, while operative intervention is generally pursued for younger patients. Early anatomic reattachment is the goal. Surgical approaches include one- or two-incision techniques, and tendon fixation methods include the use of suture anchors, bone tunnels, an Endobutton, or biotenodesis screws. Common complications after repair include transient nerve palsy, which often resolves, and heterotopic ossification. Partial ruptures are significantly less common and initially can be treated conservatively. Chronic tears are more difficult to treat because of possible tendon retraction and poor tissue quality.

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Author information

Authors and Affiliations

  1. IRCCS Policlinico San Donato, Milano, San Donato Milanese, Italy

    Paolo Arrigoni & Riccardo D’Ambrosi

  2. Ospedale San Jacopo, Pistoia, Italy

    Simone Nicoletti

  3. Physical Medicine and Rehabilitation Terme di San Petronio-Antalgik, Bologna, Italy

    Susanna Stignani Kantar

  4. PhysioMedica, Faenza, RA, Italy

    Susanna Stignani Kantar

Authors
  1. Paolo Arrigoni
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  2. Simone Nicoletti
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  3. Riccardo D’Ambrosi
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  4. Susanna Stignani Kantar
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Editor information

Editors and Affiliations

  1. Policlinico di Modena, Shoulder and Elbow Unit, D. Cervesi Hospital, Cattolica, Italy

    Giuseppe Porcellini

  2. Rizzoli Institute, Bologna, Italy

    Roberto Rotini

  3. Terme di San Petronio - Antalgik, Bologna, Physiomedica, Faenza, Italy

    Susanna Stignani Kantar

  4. Shoulder Team, ForlìCio - Collegio Italiano Osteopatia, Parma, Italy

    Silvia Di Giacomo

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Arrigoni, P., Nicoletti, S., D’Ambrosi, R., Kantar, S.S. (2018). Distal Biceps Brachii Injury. In: Porcellini, G., Rotini, R., Stignani Kantar, S., Di Giacomo, S. (eds) The Elbow. Springer, Cham. https://doi.org/10.1007/978-3-319-27805-6_27

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  • DOI: https://doi.org/10.1007/978-3-319-27805-6_27

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