FUNCTIONAL RECOVERY AND RE-INTRODUCTION TO SPORT, AFTER REPAIR OF DISTAL BICEPS TEAR BY TWO-INCISION TECHNIQUE MAYO
Introduction Three percent of all biceps tendon ruptures occur at the distal aspect, the rupture typically occuring in middle aged males after an eccentric extension load is applied to the elbow. Rupture of distal biceps tendon was once thought to be an uncommon injury, but an increase in athletic activities in middle age may account for its increase in incidence. There is an increased frequency of tendon rupture associated with use of statins and smoke.
Patients usually complain of a sudden and painful tearing sensation in the anterocubital region, with a palpable defect. Biceps squeeze test, hook test and Popeye sign are useful to the diagnosis. Testing images from MRI and ultrasound may be helpful to diagnose. Early anatomic re-attachment is the goal, no operative treatment typically results in loss of flexion and supination strength and endurance.
The objective of this study is the evaluation of the functional outcome and sport re-introduction in patients operated on for rupture of distal biceps tendon after rehabilitation.
Methods A retrospective study was done with 12 patients with a mean age of 46.41 years, who suffered biceps distal tendon tear treated by early surgery with the two incision of Mayo technique. Rehabilitation treatment was performed and functional outcomes were assessed from the sixth month of the intervention, using the Mayo Elbow Score (MES). The range of movement was measured by manual goniometer, and the force with medical research council scale.
Results Two of our 12 patients were taking statin, and three of them were smokers. The time from the break until surgery was 9.5 days on average, arrested by maintaining a splint for 5 weeks. Patients needed an average of 6 weeks of rehabilitation. Functional outcome showed a mean 95.11/100 with MES, at 6 months after surgery, which was considered excellent, with a range of motion that averaged 140°±15° and a muscular balance average of 4+/5, compared with the healthy arm. The reintroduction to usual sport was 88.9% at 10 month after surgery.
Discussion Early repair of distal biceps tear followed by a rehabilitation treatment allows a good functional recovery and reintroduction to the sport.