Distal Biceps Repair


What is a Distal Bicep Tendon Tear?

The biceps muscle, located in the front of the upper arm allows you to bend the elbow and rotate the forearm. Biceps tendons attach the biceps muscle to the bones in the shoulder and in the elbow.

Distal Biceps Tear: Although two tendons attach the biceps muscle to the bone at the shoulder, only one tendon attaches it to the elbow. This is known as the distal biceps tendon. Tears of the distal biceps tendon are usually complete and the muscle is separated from the bone. Tears of the distal biceps tendon most often result from a sudden injury or lifting a heavy object. 

Causes of Bicep Tendon Tears

Biceps tendon tear can be caused by injury such as falling with your arm outstretched or during the act of lifting heavy objects. In case of overuse, a tendon may fray and eventually tear. Other shoulder problems such as tendonitis, shoulder impingement, and rotator cuff injuries are more likely to weaken or tear the biceps tendon. Additional risk factors such as advancing age, heavy overhead activities, repetitive overhead sports, smoking, and use of corticosteroids can also result in a tendon tear.

Symptoms of Bicep Tendon Tears

The most common symptom is a sudden, severe pain in the upper arm or at the elbow, depending on where the tendon is injured. At times, you may hear a “pop”. Other symptoms include swelling, visible bruising, weakness in the shoulder or elbow, and trouble turning your arm palm up or palm down. A bulge referred to as a “Popeye Muscle,” may also appear in your arm, because the tendon is no longer holding the muscle in place properly. 

Diagnosis of Bicep Tendon Tears

Biceps tendon tear is usually diagnosed based on your symptoms, medical history, and physical examination. During the physical examination, your doctor will look for a gap in the front of the elbow. Your doctor will diagnose a partial tear by asking you to bend your arm and tighten the biceps muscle. You may have pain if there is a partial tear. X-rays may be taken to rule out other conditions causing shoulder and elbow pain. Using an MRI scan your doctor can know whether tear is partial or complete.

Treatment Options for Bicep Tendon Tears

Nonsurgical Treatment 

Conservative treatment for a proximal biceps tendon tear includes

  • Ice

  • Rest – Sling, Limit use of elbow, avoid overhead activities and heavy lifting

  • non-steroidal anti-inflammatory medications to reduce the pain and swelling

  • Physical Therapy to restore flexibility and strength

Surgical Treatment

For patients with partial tears who continue to experience symptoms despite conservative treatment or those with a full thickness tendon tear, surgical intervention is the best option.

Surgery to repair your distal biceps back to the bone is done through a small incision just below your elbow. The tendon is attached with stitches through holes drilled inside the bone or small metal implants may be used to attach the tendon to the bone.

Complications

Complications are rare and may include infection, nerve damage, re-rupture of the tendon.