Clin Orthop Surg.  2025 Apr;17(2):267-273. 10.4055/cios24185.

Distal Biceps Brachii Rupture

• Almigdad A
• Saleem S
• Malhas A

• KMID: 2565828
• DOI: http://doi.org/10.4055/cios24185

Abstract

Background
Distal biceps tendon ruptures are rare injuries that predominantly affect active men between the fourth and sixth decades, with a higher incidence in weightlifters and bodybuilders. This study aimed to comprehensively review cases involving distal biceps tendon ruptures, focusing on sociodemographic factors (such as sex, age, occupation, and smoking status), injury mechanisms, postoperative outcomes, and recorded complications.
Methods
This retrospective review examines distal biceps injuries at Royal Berkshire Foundation Trust NHS Hospital from 2017 to 2023. Analyzed data encompasses demographic information, injury mechanisms, clinical findings, and complications. Outcomes were assessed using the range of movement and Elbow Oxford Score.
Results
The average age of 73 patients (72 men and 1 woman) was 45.6 ± 9.4 years, with 75.3% falling between 36 and 55 years. Manual workers represented 46.6%, and 9.6% reported comorbidities and 6.8% steroid use. Lifting heavy objects and sports injuries were the predominant causes, constituting 43.8% and 13.7%, respectively. Most injuries (91.8%) involved complete tears, and most underwent acute surgery within the initial 4 weeks (84.9%). The most common complications were heterotopic ossification (23.3%) and neurological injury (16.4%). Ongoing weakness and fatigue were reported by 6.8%. At final follow-up, 75.7% of patients demonstrated a range of movement comparable to the contralateral side. However, 13.7% had a limited pronationsupination arch with a mean loss of 20° ± 14°, 11% had an extension lag with a mean of 15° ± 7°, and 2.7% showed a 10° flexion loss compared to the contralateral side.
Conclusions
Distal biceps injuries are rare but lead to substantial functional loss without operative treatment. Surgical repair yields positive functional outcomes. Our study aligns with existing literature, emphasizing a predominance of middle-aged men and manual workers. It underscores the impact of corticosteroids and smoking, highlights surgical efficacy, and advocates for increased research in distal biceps injury prevention and treatment understanding.

Keyword

Biceps brachii; Tendon injuries; Rupture; Tendon repair; Elbow joint