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Friday, March 17, 2000

Tell repair of chronic biceps tendon ruptures

Repair of chronic biceps tendon ruptures can be performed safely with a flexor carpi radialis tendon graft which is easily harvested from the ipsilateral extremity using a single anterior incision, according to a study in scientific exhibit 15.

"We performed a double-looped 50 percent slip of the flexor carpi radialis tendon on five patients with chronic distal biceps tendon ruptures, and fixation was done with a single anterior incision and implantable suture anchors," said co-author A. Allen Mashoof, MD, resident, Kingsbrook Jewish Medical Center, Brooklyn, N.Y.

According to Dr. Mashoof, patients had a minimum of two-year follow-up and had overall satisfaction, range of motion and no functional deficits in wrist flexion as a result of harvesting the flexor carpi radialis. All patients returned to activities of daily living, including weight lifting.

Isokinetic muscle testing demonstrated no significant difference with strength and endurance when compared to the uninjured nondominant extremity. Two patients formed adhesions within the subcutaneous tissue at the repair site, which did not require any further treatment.

"Rupture of the distal biceps tendon is a relatively uncommon injury," said Dr. Mashoof. "Failure to repair results in weakness in flexion and supination of the elbow. Chronic ruptures (greater than three months) present with special problems. The musculotendinous unit retracts and the end of the tendon forms scar tissue that makes reattachment to the radial tuberosity difficult. Several procedures have been described, including reattachment of the biceps tendon to the brachialis and use of semitendinosus or tensor fascia lata grafts. These procedures, however; have suboptimal results or require harvesting grafts from distant sites."

Co-author of the study with Dr. Mashoof is Howard J. Levy, MD, section chief, sports medicine, department of orthopaedics, Petrie Division, Beth Israel Medical Center, New York City.

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Last modified 17/March/2000 by IS