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. 2022 May 3:32:18-24.
doi: 10.1016/j.jor.2022.05.002. eCollection 2022 Jul-Aug.

Partial tear of the distal biceps tendon: Current concepts

Zaid Hamoodi  1 , Joanna Winton  2 , Vijaya Bhalaik  1
Affiliations

Partial tear of the distal biceps tendon: Current concepts

Zaid Hamoodi et al. J Orthop. .

Abstract

Background: Patients with partial rupture of the distal biceps tendon can present with vague elbow pain and weakness. Understanding of the anatomy and aetiology of this disease is essential to management. Patients can present with a single or multiple traumatic events or with a chronic degenerative history. On clinical examination, patients will have an intact tendon making the diagnosis more challenging. Clinicians, therefore, should have a high index of suspicion and should actively look for this pathology.

Objectives and rationale: This review aims to discuss the current evidence in managing partial rupture of the distal biceps tendon with a suggested treatment algorithm.

Conclusion: Several clinical tests have been described in the literature including resisted hook test, biceps provocation test, and TILT sign. However, the diagnosis is usually confirmed by a magnetic resonance scan with the arm positioned in elbow flexion, shoulder abduction, and forearm supination and commonly known as FABS MR. Partial tendon tears that involve less than 50% of the tendon can be successfully managed conservatively. Tears that include more than 50% of the tendon are more likely to fail conservative management and would benefit from surgical intervention. It is crucial, however, to involve the patient in the decision making, which is based on their objectives and needs.

Keywords: Anatomy; Diagnosis; Distal biceps tendon; Management; Partial tear.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
The anatomic footprint of the distal biceps tendon.
Fig. 2
Fig. 2
The blood supply to the distal biceps tendon. Ant.: Anterior, Post.: Posterior, Zone 1: Proximal zone, Zone 2: Middle zone and Zone 3: Distal zone.
Fig. 3a
Fig. 3a
Patient positioning for FABS MR.
Fig. 3b
Fig. 3b
FABS MR clearly showing the distal biceps tendon. Arrow pointing towards the distal biceps tendon.
Fig. 4
Fig. 4
The management algorithm used by the senior author.
See this image and copyright information in PMC

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