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Distal rupture of the biceps tendon typically occurs in middle aged men during heavy lifting with the elbow flexed 90 degrees, or when the biceps muscle contracts against unexpected resistance. The estimated incidence is 1.2 per 100,000 population per year8. The specific tests for distal biceps tendon ruptures include the hook test and the biceps squeeze test5. Acute operative fixation should be offered to all healthy patients who require strength and endurance with elbow flexion and forearm supination. Early anatomic reconstruction of the distal biceps can completely restore elbow flexion and supination strength and endurance and demonstrates higher clinical and functional outcomes. Our preferred technique is a single – incision anatomic repair of the distal biceps tendon using an EndoButton.

Distal biceps tendon rupture - a single-incision repair with EndoButton