Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Nov 30:11:1364-1372.
doi: 10.2174/1874325001711011364. eCollection 2017.

Distal Biceps and Triceps Injuries

James C Beazley  1 , Thomas M Lawrence  1 , Steven J Drew  1 , Chetan S Modi  1
Affiliations
Review

Distal Biceps and Triceps Injuries

James C Beazley et al. Open Orthop J. .

Abstract

Background: Rupture of the distal biceps and triceps tendons are relatively uncommon injuries typically occurring in middle-aged males as a result of eccentric loading of the tendon.

Methods: A literature search was performed and the authors' personal experiences reported.

Results: This review discusses the diagnosis, indications and guidelines for management of these injuries and provides a description of the authors' preferred operative techniques.

Conclusion: Whilst non-operative treatment may be appropriate for patients with low functional demands, surgical management is the preferred option for the majority of patients. We have described a cortical button technique and osseous tunnel technique utilised at our institution for distal biceps and triceps tendon fixation respectively. For biceps or triceps tendon injuries, those receiving an early diagnosis and undergoing surgical intervention, an excellent functional outcome can be expected.

Keywords: Distal biceps; Distal triceps; Elbow joint; Reconstruction; Tendon rupture.

PubMed Disclaimer

Figures

Fig. (1)
Fig. (1)
The hook test - when the biceps tendon is intact, as above, the examiner can fully insert the finger under the lateral edge of the biceps tendon. The finger passes between the biceps tendon and underlying brachialis muscle.
Fig. (2)
Fig. (2)
A: retrieval of tendon through transverse incision, taking care to identify and protect the lateral cutaneous nerve of the forearm. B: retrieved tendon is whip stitched to endobutton with 2 Orthocord.
Fig. (3)
Fig. (3)
Endobutton fixation of distal biceps. Tendon is whip stitched to Endobutton with 2 Orthocord and a 4.5mm and 7mm hole drilled in far and near cortex of radius respectively (A). Endobutton with attached tendon is passed through radius (B). Endobutton flipped (C).
Fig. (4)
Fig. (4)
X-ray confirming correct position of cortical button at level of bicipital tuberosity.
Fig. (5)
Fig. (5)
Repair of ruptured triceps tendon to bone with 2 Orthocord through 2.5mm drill holes.
See this image and copyright information in PMC

References

    1. Safran M.R., Graham S.M. Distal biceps tendon ruptures: Incidence, demographics, and the effect of smoking. Clin. Orthop. Relat. Res. 2002;(404):275–283. doi: 10.1097/00003086-200211000-00042. - DOI - PubMed
    1. Agins H.J., Chess J.L., Hoekstra D.V., Teitge R.A. Rupture of the distal insertion of the biceps brachii tendon. Clin. Orthop. Relat. Res. 1988;(234):34–38. - PubMed
    1. Seiler J.G., III, Parker L.M., Chamberland P.D., Sherbourne G.M., Carpenter W.A. The distal biceps tendon. Two potential mechanisms involved in its rupture: Arterial supply and mechanical impingement. J. Shoulder Elbow Surg. 1995;4(3):149–156. doi: 10.1016/S1058-2746(05)80044-8. - DOI - PubMed
    1. Last. Last’s anatomy regional and applied. 9th ed. New York: Churchill Livingstone; 1994.
    1. Eames M.H., Bain G.I., Fogg Q.A., van Riet R.P. Distal biceps tendon anatomy: A cadaveric study. J. Bone Joint Surg. Am. 2007;89(5):1044–1049. - PubMed

LinkOut - more resources