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Delayed presentation of distal biceps tendon tears poses new challenges
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TORONTO — Gregory I. Bain, MBBS, FRACS, PhD, of South Australia, Australia, provided an international perspective on the challenges orthopaedic surgeons face in the treatment of distal biceps tendon tears.
“We assess for flexion, abduction and supination,” he said in a presentation at the International Society of Arthroscopy, Knee Surgery & Orthopaedic Sports Medicine Congress, here.
If that examination — a FABS [flexion, abduction, and supination] view — appears typical, Bain said he performs no further investigations, especially if the patient provides a good history.
Gregory I. Bain
Surgery then could proceed as usual. Although such tears can be managed nonoperatively, he said he usually advises against it due to the loss of supination strength that often results. He urged elbow surgeons to always check for medical comorbidities, including malignancy, before operative treatment.
Bain said that delayed presentations of distal biceps tears are important.
“This is becoming an area I think we have made a lot of progress in,” he said.
For example, he used to use hamstring autograft tendons as a standard in delayed presentation cases to restore the tendon’s full 7-inch length.
“If you can get 70 degrees on the table and stretch them out, they do not require a tendon graft,” he said. Otherwise, Bain said the goal of surgery is tendon lengthening.
Reference:
Bain GI. Symposium: Challenging problems in the elbow: An international perspective — Biceps and triceps injuries. Presented at: The International Society of Arthroscopy, Knee Surgery & Orthopaedic Sports Medicine Congress; May 12-16, 2013; Toronto.
Disclosure: Bain has no relevant financial disclosures.