Revision of distal biceps rupture repair

Diagnosis, etiology and outcomes of revision distal biceps tendon reattachment Prokuski, V., Leung, N., & Leslie, B. Level of Evidence: 4 Follow recommendation: 👍 👍 Type of study: Therapeutic Topic: Distal biceps tendon re-rupture - Patient presentation and characteristics. This retrospective study assessed the clinical presentation and characteristics of patients (n = 10) who underwent a revision surgery for a previously repaired distal biceps tendon rupture. The reason for revision surgery was the presence of persistent pain since primary repair (40% of patients) or acute pain following a specific traumatic event (60% of patients up to two years post-surgery). The re-rupture rate of a distal biceps repair has been reported to be 1-6%. Hook test and MRI were unhelpful in screening or diagnosing re-rupture due to tethering around the surgical site. Three of the 10 patients had a previous re-rupture in the contralateral arm. It has been suggested that if re-rupture occurs without biceps tendon retraction, the repair is not urgent and can be performed up to two years post injury. Clinical Take Home Message: Hand therapists should immediately refer patients with a previous primary biceps tendon repair who report sudden onset of antecubital pain due to trauma. Delays in repair of re-rupture may lead to tendon retractions. On the other hand, if pain has been on-going, referral may not be as urgent. URL: https://www.jhandsurg.org/article/S0363-5023(18)31253-X/fulltext

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