Distal biceps tendon reconstruction in chronic ruptures.

The purpose of this retrospective study was to evaluate the results of anatomic reattachment with reconstruction of the distal biceps tendon using an Achilles tendon allograft in 7 male patients with chronic distal biceps ruptures. Through a 1-incision anterior approach, the tendon allograft was attached to the bicipital tuberosity by using suture anchors and then secured to the biceps remnant. Follow-up averaged 29 months. Mean elbow flexion was 145 degrees, an extension deficit of 20 degrees was observed in 1 patient, and mean pronosupination was 170 degrees. All patients had 5/5 strength in flexion and supination on manual testing, and all returned to their employment. Mean supination strength was 87% of the contralateral healthy extremity. Six achieved an excellent and 1 a good rating in the Mayo elbow performance score. No complications were encountered. This technique is an excellent alternative to nonanatomic reattachment to the brachialis muscle for patients with high functional demands in pronosupination.