Distal Biceps Repair at the Elbow
When the biceps ruptures at the elbow the impairment associated with the rupture (complete tear) causes significant limitations. There is usually a 30% loss of flexion strength at the elbow and a 40% loss of strength in supination of the forearm (rotation of the hand and wrist outwards). For this reason, surgical repair is indicated in most cases.
Multiple techniques have been described to treat distal biceps rupture. Original methods for treatment included an open incision over the region of the damaged tendon and an incision over the back of the forearm. Dr. Lenarz is able to repair the tendon through a single incision over the front of the forearm measuring around 3 centimeters.
The initial post-operatively period is focused on range of motion only and Dr. Lenarz advises his patient’s to avoid all lifting pushing and pulling with the operative arm. Failure to follow these recommendation increases the risk of the tendon being pulled away from the footprint so it is unable to heal back to the bone. After this initial period the elbow is gradually strengthened.
After the surgery, the patient will wake in the recovery room in a sling. If a “nerve block” was performed by the anesthesia doctor before the operation the arm will remain numb for 12-24 hours. This is usually done for post-operative pain control. Icing the elbow should be done liberally. This can be through the use of ice in a bag, ice packs or a circulating ice water cooler. The dressing should remain on the elbow until the first follow-up visit.