Reconstruction with interference screw of ruptured distal biceps brachii tendon at level of insertion into radial tuberosity: a case report

Gusti Ngurah Putra Stanu, I. Gusti Ngurah Wien Aryana, Ivander Purvance, Ni Made Puspa Dewi Astawa


Distal biceps tendon rupture is a relatively rare injury. The incidence of distal biceps rupture is 1.2 cases per 100,000 patients per year, with the average age is 47 years old and the majority is male patient with dominant extremity. A 43 years old male presented with pain of the left elbow and weakness to flex and supinate the forearm following gymnastic activity. He heard pop sound on his left elbow during lifting dumbbell and followed by a sudden pain on his arm and weakness to flex and supinate the elbow. The USG examination were performed and confirmed there was a rupture on the distal biceps tendon at the level of insertion. Durante operation confirmed a complete rupture of distal biceps tendon. A Henry approach incision is performed to expose radial tuberosity, and the ruptured tendon was reconstructed by anchored into the tuberosity of radius with bioabsorbable screw. After closing the incision, patient is immobilized by cast in 60 to 90o elbow flexion and neutral pronosupination. Distal biceps tendon rupture can be successfully repaired by single anterior approach using anatomical anchor on radial tuberosity, so that can avoid posterior approach and associated proximal radioulnar synostosis risk while conserving interosseous membrane.


Biceps, Reconstruction, Rupture, Screw, Tendon

Full Text:



Miyamoto Ryan G, Florian E, Peter JM. 2010. Distal Biceps Tendon Injuries. J Bone Joint Surg Am. 2010;92:2128-38.

Gallinet D, Dietsch E, Barbier-Brion B, Lerais JM, Obert L. Suture anchor reinsertion of distal biceps rupture: clinical results and radiological assessment of tendon healing. Orthopaed Traumatol: Surg Res. 2011 May 1;97(3):252-9.

Grégory T, Roure P, Fontès D. Repair of distal biceps tendon rupture using a suture anchor: description of a new endoscopic procedure. Am J Sports Med. 2009 Mar;37(3):506-11.

Al-Taher M, Wouters DB. Fixation of acute distal biceps tendon ruptures using Mitek anchors: a retrospective study. Open Orthopaed J. 2014;8:52.

Pina S, Ferreira JM. Bioresorbable plates and screws for clinical applications: a review. J Healthcare Engin. 2012;3(2):243-60.

Khan W, Agarwal M, Funk L. Repair of distal biceps tendon rupture with the Biotenodesis screw. Archiv Orthopaed Trauma Surg. 2004 Apr 1;124(3):206-8.

Mazzocca AD, Bicos J, Arciero RA, Romeo AA, Cohen MS, Nicholson G. Repair of distal biceps tendon ruptures using a combined anatomic interference screw and cortical button. Techn Should Elbow Surg. 2005 Jun 1;6(2):108-15.

Aldridge JW, Bruno RJ, Strauch RJ, Rosenwasser MP. Management of acute and chronic biceps tendon rupture. Hand Clin. 2000 Aug;16(3):497-503.

Boileau P, Krishnan SG, Coste JS, Walch G. Arthroscopic biceps tenodesis: a new technique using bioabsorbable interference screw fixation. Arthroscopy: J Arthroscop Related Surg. 2002 Nov 1;18(9):1002-12.

Morgan CD, Gehrmann RM, Jayo MJ, Johnson CS. Histologic findings with a bioabsorbable anterior cruciate ligament interference screw explant after 2.5 years in vivo. Arthroscopy: J Arthroscop Related Surg. 2002 Nov 1;18(9):1-6.