Failure of distal biceps repair by gapping.

Autor: Rashid, Abbas, Copas, David, Watts, Adam C.
Předmět:
Zdroj: Shoulder & Elbow; Jul2016, Vol. 8 Issue 3, p192-196, 5p
Abstrakt: Background We describe the clinical, radiological and surgical findings of failed distal biceps repair by gapping and report the functional outcomes following revision repair. Methods A retrospective review of five consecutive patients was conducted. Patients presented with radial-sided forearm pain after their distal biceps fixation. All patients had less than 5 cm of retraction of the biceps muscle belly, a palpable tendon although the manoeuvre was painful with weakness on resisted supination. Flexed abducted supinated magnetic resonance imaging (FABS MRI) showed a gap between the distal end of the tendon and the footprint on the radial tuberosity. Results Mean FEA score at presentation was 44/100 (35 to 49). Mean time to re-operation was 18 months (range 4 months to 36 months). At revision, the distal end of the tendon was retracted and not making contact with the bone. All cases were revised to an in-bone endobutton repair. Mean postoperative Functional Elbow Assessment (FEA) scores undertaken at a mean of 14 months (range 5 months to 22 months) after revision improved to 95/100 (90 to 100). Conclusions Patients presenting with persistent radial sided forearm pain and weakness on provocative testing after distal biceps repair with a seemingly intact repair should be investigated with FABS MRI to look for evidence of failure of repair by gapping. Revision repair with an anatomic in-bone technique can lead to good results. [ABSTRACT FROM AUTHOR]
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