Biceps tendon rupture of the elbow
What is a biceps tendon disruption?
When the biceps tendon ruptures at the elbow, it is torn from where the elbow meets the radius. The radius juts out slightly at the point where the biceps tendon joints, known as the radial tuberosity. Although the tendon usually pulls completely away from the bone insertion, some tendon tears are incomplete.
Biceps tendon rupture usually causes some degree of impairment because the biceps muscle is important for both bending the elbow (called elbow flexion) and turning the palm face up (called forearm supination).· Studies have shown that distal tendon rupture of this structure may result in about a 30 percent loss of elbow bending strength and about a 40 percent loss of strength in turning the palm up.
How does biceps tendon disruption occur?
What increases the risk of developing biceps tendon disruption?
What are the symptoms of biceps tendon rupture?
How is biceps tendon rupture diagnosed?
Physical exam is reliable in the vast majority of cases with a visible deformity above the elbow crease, tenderness along the course of the tendons’ attachment to its radial insertion and weakness with forearm supination against resistance.
Are there any special tests?
How is biceps tendon rupture treated?
Initial treatment consists of medication and ice to relieve the pain, and a sling may be recommended for comfort.
Historically, surgical treatment was unusual because it was believed that long-term function of the tendon was not compromised when it was left alone. But more recent studies have revealed that some patients continue to suffer from significant deficits in strength, particularly in movements requiring forearm supination (e.g., opening doors, opening jars, using screwdrivers, etc.)· Non-operative treatment may be preferable for those patients whose affected arm is their non-dominant one, who want to avoid surgery or who are less active.
Most patients are candidates for surgical reattachment of the biceps tendon. Surgery is usually recommended as soon as is reasonable after the injury, ideally within 3 weeks, to minimize retraction of the torn tendon and to take advantage of the healing environment. Delay in surgery may result in inability to re-attach the tendon due to muscle retraction. Operative treatment requires re-attachment of the tendon to its normal insertion on the radial tuberosity.
What are the potential complications from treatment?
Possible complications of non-operative treatment include:
Possible complications of operative treatment include:
When can you return to your sport/activity?
How can a biceps tendon disruption be prevented?