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What is Distal Biceps Repair?

distal-biceps-repair

The biceps is a large muscle located in the front of your upper arm and runs from the shoulder to the elbow joint. It is attached to the bones of the shoulder and elbow by tendons. The distal biceps tendon is the area where the two bicep muscles come together and attach to the forearm via the radial tuberosity near the elbow.

Distal biceps repair is a surgical procedure to restore a ruptured or torn distal biceps and tendon, caused by an injury. 

Indications for the Procedure

The typical indications for distal biceps repair include:

  • “Pop” or tear felt in the front of the elbow 
  • Severe pain around the crease of the elbow
  • Bruising and swelling around the front of the elbow
  • Weakness in bending of the elbow or twisting the forearm
  • Warmth in the elbow and cramping in the arm
  • Substantial pain and weakness of the entire upper extremity (shoulder to hand)

Preparation 

Dr. Southard will explain the procedure, its complications and benefits, and answer any questions you may have. 

Additionally, you may be told:

  • To avoid certain medicines (if applicable) before the surgery 
  • To arrange an escort to drive you home after the surgery
  • To fast after midnight prior to your surgery

How is the Distal Biceps Repaired?

The distal biceps can be repaired through a single incision (front of the elbow) or a double incision (front and back of the elbow) technique.

During the procedure:

  • You will be administered general anesthesia or a regional block. 
  • Small incisions are made near the elbow where the torn or ruptured end of the biceps located. 
  • Any damaged tissues are removed using specialized instruments.
  • Small holes are then drilled into your forearm bone (radius bone).
  • A tiny metal implant known as an anchor is pressed into the forearm bone.
  • Strong threads (sutures) are inserted into the distal biceps tendon. 
  • The sutures are attached to the anchor and the biceps is pulled back.
  • The biceps is reattached and fixed to the forearm bone with strong anchoring stitches.
  • The incision is closed with stitches and a dressing is applied.
  • Your elbow is protected with the use of a brace and a sling. 

More serious or chronic injuries may require a graft (transplanted tissue/tendon) to repair the distal biceps.

Complications  

Complications are generally rare and temporary.  The most common complication is irritation or injury to the sensory nerves of the elbow or the forearm. 

Other potential complications are: 

  • Numbness, tingling or weakness in the forearm
  • Pain and/or stiffness in the elbow and arm  
  • The need for additional surgery due to: 
  1. Infection or bleeding into the elbow joint (rare)
  2. Re-rupture of the repaired distal biceps and tendon 

After-Surgery Care

As you recover, the Dr. Southard will instruct you on how to:

  • Wear an immobilizing device(hinged brace) on your elbow or arm for 4 to 6 weeks 
  • Keep the surgery site dry to decrease the chance of infection 
  • Protect the repair by restricting your activities for at least 3 months
  • A more specific protocol will be specialized based on your surgical case.

Benefits  

Distal biceps repair can help you to: 

  • Regain strength and a full range of motion
  • Restore normal function of the elbow
  • Return to normal activities
  • American Academy of Orthopaedic Surgeons
  • American Shoulder and Elbow Surgeons
  • Orthopaedic Trauma Association
  • Weill Cornell Medicine
  • AANA Advancing the Scope