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Hogea B, Patrascu JM, Abu-Awwad SA, Suba MI, Bolovan A, Stoianov AG, Abu-Awwad A. Comparative Analysis of Surgical Approaches for Distal Biceps Tendon Rupture: Single-Incision Technique versus Double-Incision Technique. J Clin Med 2023; 12:6423. [PMID: 37835067 PMCID: PMC10573459 DOI: 10.3390/jcm12196423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/14/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023] Open
Abstract
Background: This study aimed to compare the outcomes of the single-incision technique with a distal biceps repair system versus the modified double-incision technique, specifically the Morrey-modified approach, Krackow sutures, and drill holes, for the management of acute and chronic distal biceps tendon rupture. The study was conducted at the Orthopedic-Traumatology Clinic II of SCJUPBT Timisoara, Romania, between 2014 and 2022. Methods: A total of sixty-nine patients with acute distal biceps tendon rupture and five patients with chronic distal tendon rupture were included in the study. Forty-eight cases underwent the single-incision technique with the distal biceps repair system, while twenty-four patients were treated with the modified double-incision technique. Results: Both surgical techniques demonstrated favorable outcomes in terms of successful tendon repair and functional restoration. However, the single-incision technique exhibited slightly superior results in terms of patient satisfaction, range of motion, and postoperative rehabilitation. The modified double-incision technique showed comparable outcomes but had a higher incidence of complications, particularly related to wound healing. Conclusion: The single-incision technique with the distal biceps repair system and the modified double-incision technique, including the Morrey-modified approach, Krackow sutures, and drill holes, are effective surgical approaches for the management of distal biceps tendon rupture. The single-incision technique yielded better functional outcomes and patient satisfaction, while the modified double-incision technique had a higher risk of complications. Further research with larger sample sizes and longer follow-up periods is necessary to validate these findings and determine the most appropriate surgical approach for distal biceps tendon rupture.
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Affiliation(s)
- Bogdan Hogea
- Department XV, Discipline of Orthopedics-Traumatology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (B.H.); (J.-M.P.J.); (A.G.S.); (A.A.-A.)
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania;
- Research Center University Professor Doctor Teodor Șora, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Jenel-Marian Patrascu
- Department XV, Discipline of Orthopedics-Traumatology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (B.H.); (J.-M.P.J.); (A.G.S.); (A.A.-A.)
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania;
- Research Center University Professor Doctor Teodor Șora, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Simona-Alina Abu-Awwad
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania;
- Department XII, Discipline of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
| | - Madalina-Ianca Suba
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
- Dr. Victor Babeș Infectious Diseases and Pneumophthisiology Hospital Timisoara, 300310 Timisoara, Romania
| | - Andrei Bolovan
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania;
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
| | - Anca Gabriela Stoianov
- Department XV, Discipline of Orthopedics-Traumatology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (B.H.); (J.-M.P.J.); (A.G.S.); (A.A.-A.)
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania;
| | - Ahmed Abu-Awwad
- Department XV, Discipline of Orthopedics-Traumatology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (B.H.); (J.-M.P.J.); (A.G.S.); (A.A.-A.)
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania;
- Research Center University Professor Doctor Teodor Șora, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
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Razaeian S, Zhang D, Harb A, Meller R, Krettek C, Hawi N. Distal Biceps Tendon Repair Using a Modified Double-Incision Technique: Patient-Reported Outcomes With 10-Year Follow-up. Orthop J Sports Med 2020; 8:2325967120944812. [PMID: 32913874 PMCID: PMC7444136 DOI: 10.1177/2325967120944812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/08/2020] [Indexed: 12/03/2022] Open
Abstract
Background: In the setting of complete distal biceps tendon rupture, surgical repair has become the standard of care to restore optimal elbow function, but the optimal approach and method of tendon fixation are still subjects of debate and have remained controversial for more than half a century. Purpose: To evaluate patient-reported long-term outcomes after distal biceps tendon repair using a modified double-incision technique. Study Design: Case series; Level of evidence, 4. Methods: We reviewed primary distal biceps tendon repairs after isolated tendon rupture using the modified muscle-splitting double-incision approach and transosseous suture fixation technique described by Morrey et al (1985), which had been performed at our level 1 trauma center between January 2000 and December 2013. Outcome measures included the subjective elbow value (SEV), the Oxford Elbow Score (OES) with its 3 domains (function, pain, and social-psychological), a self-performed hook test, and the 3-level version of the EuroQoL 5-dimensional instrument (EQ-5D-3L) as a measure of health status. Levels of overall satisfaction were determined by asking whether the patient would consent to the operation again. In addition, patients were asked to report any complications. Results: A total of 30 patients met the inclusion criteria, and 25 patients were available for the survey. Mean age at the time of rupture was 47 years. All patients were male. Mean follow-up was 120 months (range, 57-207 months). The follow-up rate was 83.34%. The following outcome results were obtained: SEV, 88.16% ± 25.18%; OES, 43.80 ± 10.56 out of 48 points; OES Pain, 92.50% ± 23.03%; OES Function, 92.25% ± 22.19%; OES Social-Psychological, 89% ± 23.68%; EQ-5D-3L, 0.93 ± 0.21. All patients described a negative hook test. Patient-reported complications included painless limitation in forearm rotation in 8% of patients (n = 2); reduced flexion and forearm rotation strength with and without pain in 8% (n = 2) and 4% (n = 1), respectively; synostosis after 1 year requiring revision surgery in 4% (n = 1); and transient wrist drop in 4% (n = 1). The overall complication rate was 28% (7/25), and 96% (n = 24) would consent to the operation again. Conclusion: Despite the cited approach-related morbidity, we report an excellent patient-reported long-term outcome for the double-incision distal biceps repair technique.
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Affiliation(s)
- Sam Razaeian
- Trauma Department, Hannover Medical School, Hannover, Germany
| | - Dafang Zhang
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Afif Harb
- Trauma Department, Hannover Medical School, Hannover, Germany
| | - Rupert Meller
- Trauma Department, Hannover Medical School, Hannover, Germany
| | | | - Nael Hawi
- Trauma Department, Hannover Medical School, Hannover, Germany
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