Rupture of the distal biceps brachii. Report of four cases

Abstract

Introduction: brachial distal biceps tendon rupture is a rare lesion; it represents only 3 % of all biceps injuries and mainly affects the dominant arm. It is common in middle-aged men and extremely rare in women. In the last decade cases have increased due to the use of steroids and smoking, among other risk factors.

Presentation of cases: four patients with rupture of the distal biceps are presented; they were attended at the Service of Orthopedics and Traumatology of the Provincial General Teaching Hospital "Dr. Antonio Luaces Iraola". In all of them the antecedent of the injury was an effort with the elbow flexed and supinated forearm. The treatment was surgical; one patient was operated by double approach and the remaining three by the anterior route; in one case, transosseous fixation was carried out, in two fixation with anchors, and in the fourth, both methods were used. At five months, complete strength was allowed and a follow up for 18 months was indicated. One case presented heterotopic calcification as a complication; the evaluation of patients according to the scale of the Mayo Clinic was excellent in three cases and good in one.

Conclusions: the technique based on a single anterior incision, with fixation of the distal biceps tendon to the bone through the harpoons, is effective; its complications rate is low. Early mobilization makes possible for patients to return to activities of daily living, work and sports.