Management of Distal Biceps Tendon Rupture: Overview of Surgical and Conservative Treatment
DOI:
https://doi.org/10.12775/QS.2026.52.69449Keywords
distal biceps tendon, hook test, conservative treatment, single-incision, double-incision, interosseous nerve, heterotopic ossificationAbstract
Introduction. Distal biceps tendon rupture is an uncommon injury that predominantly affects middle-aged men. It results in pain and significant loss of supination and flexion strength of the forearm, leading to functional impairment in activities of daily living. Management options include both conservative and surgical approaches, with the choice of treatment depending on patient-specific factors such as age, activity level, and functional demands.
Aim of study. The objective of this study is to evaluate surgical and non-surgical treatment options for distal biceps tendon rupture with focus on single-incision and double-incision techniques, most common complications and different fixation methods. Furthermore, the study seeks to provide clinicians with guidance on accurate diagnosis and optimal treatment selection tailored to individual patient needs.
Results. The estimated incidence of distal biceps tendon rupture ranges from 1.2 to 2.55 cases per 100,000 individuals, with a rising trend observed in recent years. The injury most commonly occurs due to excessive eccentric loading of the biceps muscle during elbow flexion followed by sudden extension. Recognized risk factors include smoking, repetitive mechanical stress, tendon impingement, increased radial tuberosity height or volume, obesity, and corticosteroid use.
Conclusion. A wide range of treatment strategies for distal biceps tendon rupture have been described in the literature, varying from conservative management such as wait-and-see, physiotherapy, and corticosteroid injections in older or low-demand patients, to surgical anatomical reinsertion using either single-incision or double-incision techniques. Reported fixation techniques include cortical button, interference screw, suture anchors, bone tunnel, and intramedullary fixation. Complications of surgical treatment, though rare, include predominantly injury to the posterior interosseous nerve and heterotopic ossification.
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Copyright (c) 2026 Michał Olejnik, Kamil Swoboda, Kamil Pielusiński, Alicja Pyzik, Aleksandra Włodarczyk, Zuzanna Wiater, Karolina Brankowska, Marta Jakubowska, Witold Kądziołka, Szymon Domagała
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