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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 1, 103-106.
doi: 10.1302/0301-620X.90B1.19285  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Reattachment of the distal tendon of biceps

FACTORS AFFECTING THE FAILURE STRENGTH OF THE REPAIR

M. Kettler, MD, Orthopaedic Surgeon1; M. J. Tingart, MD, PhD, Orthopaedic Surgeon2; J. Lunger, MD, Assistant Doctor3; and V. Kuhn, MD, Scientist4

1 Department of Orthopaedics
2 Department of Orthopaedic Surgery, University of Regensburg, Kailser Karl V Allees, 93077 Bad Abbach, Germany.
3 Surgical Department, Redcross Hospital Munich, Nymphenburger 163, 80634 Munich, Germany.
4 Department of Trauma Surgery and Sports Medicine, Medical University Innsbruck, Anichstrasse 36, A-6020 Innsbruck, Austria.

Correspondence should be sent to Dr M. Kettler; e-mail: mark.kettler{at}gmx.de

Operative fixation is the treatment of choice for a rupture of the distal tendon of biceps. A variety of techniques have been described including transosseous sutures and suture anchors. The poor quality of the bone of the radial tuberosity might affect the load to failure of the tendon repair in early rehabilitation.

The aim of this study was to determine the loads to failure of different techniques of fixation and to investigate their association with the bone mineral density of the radial tuberosity.

Peripheral quantitative computed tomography was carried out to measure the trabecular and cortical bone mineral density of the radial tuberosity in 40 cadaver specimens. The loads to failure in four different techniques of fixation were determined.

The Endobutton-based method showed the highest failure load at 270 N (SD 22) (p < 0.05). The mean failure load of the transosseous suture technique was 210 N (SD 66) and that of the TwinFix-QuickT 5.0 mm was 57 N (SD 22), significantly lower than those of all other repairs (p < 0.05). No significant correlation was seen between bone mineral density and loads to failure.

The transosseous technique is an easy and cost-saving procedure for fixation of the distal biceps tendon. TwinFix-QuickT 5.0 mm had significantly lower failure loads, which might affect early rehabilitation, particularly in older patients.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General