Partial Tears of the Distal Biceps Brachii Tendon: A Systematic Review of Surgical Outcomes

J Hand Surg Am. 2016 Jul;41(7):e175-89. doi: 10.1016/j.jhsa.2016.04.019. Epub 2016 May 20.

Abstract

Purpose: To systematically review the literature regarding surgical outcomes for treatment of partial tears of the distal biceps brachii tendon.

Methods: This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. A systematic review of the literature regarding treatment of partial tears of the distal biceps tendon was conducted using PubMed, Embase, and Cochrane. Inclusion criteria consisted of studies in the English language on the treatment of partial distal biceps tendon tears. Exclusion criteria consisted of (1) studies without outcome data, (2) studies that did not specify the degree of distal biceps tendon tear (ie, complete rupture vs partial tear), and (3) studies without partial tear subgroup data. Two investigators independently reviewed the abstracts from all identified articles.

Results: Only 5 patients who underwent successful nonsurgical treatment were identified; all were treated with different algorithms, and because of the small number, outcomes for nonsurgical treatment are not included in this review. Therefore, 19 studies involving 86 partial tears that underwent surgical treatment are reported; at least 65 of these received a trial of nonsurgical treatment before surgery. Surgery resulted in 94% satisfactory clinical outcomes. Of the 16 studies (n = 83) that specified the presence or absence of surgical complications, lateral antebrachial cutaneous nerve paresthesia (17%), posterior interosseous nerve palsy (6%), elbow discomfort (2%), surgical revision (2%), and asymptomatic heterotopic ossification (1%) were reported.

Conclusions: Surgical treatment including tendon tear completion and anatomic repair to the radial tuberosity can yield satisfactory results and appears to provide predictable outcomes. Further research is necessary to better define the optimal regimen and duration of nonsurgical treatment, as well as the indications for surgery.

Type of study/level of evidence: Therapeutic IV.

Keywords: Anterior elbow pain; distal biceps tendon; partial tear; tendinopathy; tendon rupture.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Conservative Treatment / statistics & numerical data
  • Elbow / injuries*
  • Elbow / surgery
  • Humans
  • Orthopedic Fixation Devices
  • Orthopedic Procedures / adverse effects
  • Orthopedic Procedures / statistics & numerical data
  • Patient Outcome Assessment
  • Postoperative Complications
  • Tendon Injuries / therapy*