Minimally Invasive Distal Biceps Tendon Repair

Abstract

Aim: To describe a new modified technique for minimally invasive distal biceps tendon repairs.

Materials and Methods: A case report and surgical description are provided to illustrate the surgical technique and expected outcomes.

Results: We used a 1.5cm ulna-based incision two fingerbreadths below the elbow flexion crease with blunt dissection of the subcutaneous tissue to avoid damage to the lateral cutaneous nerve of the forearm. We then incised the bicipital aponeurosis along its fibres and utilised blunt dissection radial to the brachial artery to access the native distal biceps tendon footprint on the radius and to retrieve the distal biceps tendon. Reinsertion of the tendon could then be performed with a number of existing techniques, however, this approach ensured optimal angle to insert the biceps tendon distal and posterior to the radial tuberosity and therefore into the native footprint for optimal biomechanical function of the repair.

Conclusions: We describe a minimally invasive approach for distal bicep repair that provides an excellent cosmesis, a low risk to the lateral cutaneous nerve of the forearm and an optimal angle for fixation of the distal biceps to its native footprint, which we believe optimises early functional outcomes.