Distal Biceps Rupture
The biceps muscle is attached at the shoulder by two tendons and is attached on the forearm by one tendon. Tears can occur at both ends. The distal insertion point is the radial tuberosity. Tears at the radial tuberosity are less common than at the proximal insertion but tend to cause more noticeable weakness in flexing and pronating your forearm. Once this attachment is disrupted, it will not heal on its own.
Common causes of distal biceps ruptures involve activities that cause forced extension of a flexed arm. Examples include heavy lifting or catching a heavy falling object. Other risk factors include male sex, age over 30 years old, smoking, and a history of steroid use.
SYMPTOMS & DIAGNOSIS
Symptoms: Patients will usually feel a pop when the tendon pulls away from the bone. Initially, pain, swelling and bruising will occur. Other symptoms include a bulge in the upper arm and weakness with elbow flexion and with supination.
Diagnosis is made by history, physical examination, and ultrasound. X-rays are obtained to rule out any other bony abnormalities. MRI con confirm whether the tear is partial or complete.
In order to regain function and strength, surgery is recommended. The tendon is located and then reattached to its original insertion on the radial tuberosity. A hinged elbow brace is used to protect the tendon during the healing phase. Physical therapy is recommended to help regain strength, range of motion and facilitate return to activity. A reasonable time frame for return to activities is 3-4 months.