Outcomes and Complications After Repair of Complete Distal Biceps Tendon Rupture with the Cortical Button Technique
Bibliographic record
Abstract
Numerous surgical techniques have been described for the repair of complete distal biceps tendon ruptures. However, the outcome of repair with cortical button fixation has not been extensively evaluated. The hypothesis of the present study was that elbow strength and range of motion would be less than normal after repair but that ongoing disability would be minimal as measured with use of the Disabilities of the Arm, Shoulder and Hand (DASH) score. METHODS: We performed a retrospective cohort study of patients with complete distal biceps tendon rupture that was repaired with cortical button fixation via a 1-incision anterior approach. Outcome was assessed on the basis of elbow range-of-motion and strength measurements, DASH scores, and radiographs of the operatively treated elbow. Descriptive statistics were generated for patient demographics and outcome variables. Strength was assessed with limb-symmetry index, and range of motion was evaluated with paired t tests. RESULTS: Sixty male patients consented to this study. The average age at the time of follow-up was 49.6 ± 7.8 years, and the average time from injury to follow-up was 3.7 ± 1.7 years. The mechanism of injury included lifting heavy objects (62%) and sporting activities (25%). Elbow flexion and supination range of motion were not different between the operatively treated and contralateral arms. The operatively treated elbow demonstrated decreased flexion strength (96% of that on the contralateral side) and supination strength (91% of that on the contralateral side). The findings did not change when controlling for hand dominance. The mean DASH score was 7.9 ± 11.4, which is not significantly different from the normative value for the general population. Postoperative complications included heterotopic ossification (Brooker class I [29 patients] or II [5 patients]), neurapraxia (7 patients), and rerupture (3 patients). CONCLUSIONS: The repair of complete distal biceps tendon ruptures with cortical button fixation was associated with decreased strength in elbow flexion and forearm supination compared with the contralateral arm, although the differences were small and likely were not clinically important. The complication rate was relatively high; however, most complications were minor and were associated with minimal disability, as reflected by the DASH scores. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| 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 source (direct Gemma or distilled Codex), 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".