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Hand Wrist Elbow

Distal Biceps Tendon Rupture

What is a distal biceps tendon rupture?

The biceps is the main muscle on the front of the arm that assists us in bending our elbow and rotating our forearm. The muscle attaches to the forearm bone through a tendon, which acts like a rope at the end of the muscle. A distal biceps tendon rupture is a tear of the tendon from the forearm bone (radius). Because the biceps is responsible for strength and turning the forearm, such as to open doors or twist a screw driver, ruptures result in weakness and pain with attempted loading. Ruptures of the distal biceps tendon are almost always caused by a sudden injury to the elbow. This can happen when lifting objects that are too heavy, resulting in the elbow being forced straight when the bicep is under tension. This tears the biceps muscle and tendon from the bone. Experts at Midwest Orthopaedics at Rush Hand, Wrist & Elbow Institute in Chicago can evaluate and repair a distal biceps tendon rupture with the most advanced medical techniques. In fact, doctors from the Institute developed the surgical methods used to most effectively repair the tendon.

What are the symptoms of a distal biceps tendon rupture?

When the distal biceps tendon is ruptured or torn, patients experience sudden pain often followed by bruising or swelling above or below the elbow. Over time, other muscles in the arm try to compensate for the loss, so the arm still remains fairly useful. However, approximately half of the arm strength is lost when the biceps tears which makes it difficult to do certain tasks, like turning an object with force.

Common symptoms include:

  • Swelling and bruising around the elbow
  • Difficulty twisting the forearm
  • Difficulty bending the elbow
  • A bulge in upper arm where biceps muscle has moved
  • Sudden elbow pain after injury
  • A snapping sound or a sensation of a "pop" during an injury

How is a distal biceps tendon rupture diagnosed?

Typically, a history and a physician examination are all that is necessary to diagnose a distal biceps tendon rupture. The physicians at MOR will often recommend an X-ray to rule out any bone injury or an MRI to determine the extent of tendon damage.

What are the treatments for distal biceps tendon ruptures?

Surgery is usually the only option for those who want to restore function to the arm after a distal biceps tendon rupture and should be performed within a couple weeks of the injury. If early treatment is not received, complications can arise from scar tissue growth on the tendon and muscle as it tries to repair itself. After that, direct repair may not be possible.

There are two surgical options to reattach the biceps tendon to the forearm. Both surgeries can be performed using minimally invasive techniques. One surgical option is to stitch the tendon to holes made in the radius bone. The other uses a small metal device to attach the tendon to bone. Physicians at Midwest Orthopaedics at Rush Hand, Wrist & Elbow Institute will carefully explain the best option for each patient. As noted above, these physicians were the first to develop some of the minimally invasive repair methods currently available. After surgery, supervised therapy may be needed to ensure optimal recovery. However, a full functional recovery is most common.

Drs. Mark Cohen, John Fernandez and Robert Wysocki are experienced physicians with the Midwest Orthopaedics at Rush (MOR) Hand, Wrist & Elbow Institute in Chicago. They perform surgery at Rush University Medical Center (Chicago) and Rush Oak Park Hospital.

For additional information about the Midwest Orthopaedics at Rush Hand, Wrist & Elbow Institute, please call 855 312 HAND (855.312.4263) or schedule an appointment.

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