Rupture Biceps Tendon Insertion

A rupture of the biceps tendon at its insertion, also known as a distal biceps tendon rupture, occurs when the tendon attaching the biceps muscle to the radius bone in the forearm tears. This type of injury is less common than a rupture of the proximal biceps tendon (which is closer to the shoulder), but it can be quite serious.

Anatomy:

– Biceps Brachii Muscle: The biceps muscle has two tendons at its upper end (proximal) and one tendon at its lower end (distal). The distal tendon attaches the biceps muscle to the radial tuberosity, a bony prominence on the radius bone in the forearm.

Causes

Acute Trauma

The most common cause is a sudden injury, typically when the elbow is forced straight against resistance, such as when lifting something heavy.

Degeneration

Over time, the tendon can weaken due to repetitive use or underlying degenerative conditions, making it more susceptible to rupture.

Symptoms

– Sudden Pain: A sharp, sudden pain in the elbow or the front of the elbow, often described as a “pop” or “tear” sensation.
– Weakness: Significant weakness in the affected arm, particularly with activities involving supination (rotating the forearm) or flexion (bending the elbow).

– Deformity: The biceps muscle may retract upwards towards the shoulder, causing a noticeable bulge (often called the “Popeye sign”).
– Bruising and Swelling: Rapid bruising and swelling around the elbow and forearm.

Diagnosis

– Physical Examination: A healthcare provider may use specific tests, like the hook test, to assess the integrity of the biceps tendon.

– Imaging: An MRI or ultrasound can confirm the diagnosis by visualizing the tear and assessing its severity.

Treatment

– Non-Surgical: In some cases, especially for older or less active individuals, non-surgical treatment might be recommended, which involves physical therapy to strengthen the surrounding muscles.

– Surgical Repair: The preferred treatment for active individuals or those requiring full strength is surgical reattachment of the tendon to the bone. Surgery is typically performed within 2-3 weeks after the injury for optimal results.
– Techniques: Different surgical techniques may be used, including single-incision or double-incision approaches, and various methods of securing the tendon to the bone.

Recovery

– Post-Surgery: Recovery involves a period of immobilization followed by physical therapy. Full recovery, including return to normal activities and sports, can take several months.

– Risks: Potential complications include stiffness, infection, and a recurrence of the rupture, although these are relatively rare.

Prognosis

With timely surgical intervention and proper rehabilitation, most patients regain full strength and function of the biceps muscle.

However, delayed treatment may result in reduced strength and functional limitations.

If you suspect a biceps tendon rupture, it’s essential to seek medical attention promptly for accurate diagnosis and appropriate treatment.

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