CHRONIC DISTAL BICEPS TENDON RUPTURE: RETROSPECTIVE REVIEW OF OUTOCOMES OF A NOVEL TECHNIQUE OF RECONSTRUCTION WITH TENDON GRAFT
Bibliographic record
Abstract
Introduction The biceps brachii muscle is the primary forearm supinator and a secondary elbow flexor. The pathophysiology of distal tendon ruptures is still unclear. Patients with chronic rupture presenting 4–6 weeks after the original injury often due to mis-diagnosis or neglect have been, until recently treated non-operatively. The chronic case of biceps tendon rupture poses a surgical challenge due the retraction of the muscle and scarring or resorption of the tendon that may make it impossible to reattach primarily. A novel technique of reconstruction using tendon graft has been developed by the author. The study aims to measure subjective and objective outcomes of reconstruction with this technique. Methods This is a retrospective review of nine patients (mean age 47±10) treated with tendon reconstruction an average of 17 months following injury. Patients were evaluated and graded for bicep contour, range of motion, Mayo Elbow Performance Index (MEPI) and for bilateral elbow flexion and supination torque on a Biodex System 4 Pro dynamometer. Patient reported outcome questionnaires were also collected. Results The mean Disabilities of the Arm, Shoulder, and Hand score (DASH), American Shoulder and Elbow Society score (ASES), and Mayo Elbow Performance Index (MEPI) were 11±10, 91±10, and 88±14 respectively. Eighty of nine subjects were somewhat or very satisfied with the reconstruction. Biceps contour was 4.7 cm above the antecubital fossa on the operative side versus 3.9 cm on the nonoperative side. No statistically different strength discrepancies were noted between the operative and nonoperative sides when comparing isometric supination strength (p=0.42) and flexion strength (p=0.17), as well as peak supination torque at 90 degrees of elbow flexion (p=0.09). Discussion Reconstruction of chronic distal biceps tendon rupture with tendon graft resulted in low patient-reported disability and high patient satisfaction. No statistically different values in isokinetic supination and elbow flexion strength were noted between operative and nonoperative sides. No loss of ROM was noted as a result of the reconstruction.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".