NYU Langone orthopedic surgeons offer distal biceps tendon reconstruction surgery when a rupture has been neglected and has caused the distal biceps tendon to shorten, so that it’s impossible to use repair surgery to attach it to the radius, a bone in the lower arm.
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Distal biceps tendon reconstruction surgery may also be an option for people who have a chronic injury, meaning that the injury occurred more than four to six weeks ago, and that scar tissue has formed in that time. It may also be an option for those who have reinjured their tendon after a previous biceps tendon repair surgery.
Our orthopedic surgeons are internationally known experts in distal biceps tendon reconstruction and offer a full range of surgical approaches for this injury. Reconstruction can help restore arm strength and function in people who are active, who perform physical labor, or who want to return to sports. The procedure requires a comprehensive rehabilitation program to restore range of motion and strength in your arm.
Reconstruction of the biceps tendon requires a tissue graft. This tissue, called an allograft, acts as a strut between the remaining original biceps tendon and an insertion point of the graft into the bone, allowing the function of the biceps tendon to be restored.
For this reconstruction procedure, surgeons make a single incision on your inner elbow and drill a small hole through the top of the radius. They place one end of the graft through the hole and then fix it to the radius using a surgical button and screw. They then use high-strength sutures to attach the other end of the graft to the biceps tendon. They close the incision on the inner elbow with sutures.
For double-incision reconstruction, surgeons make an incision across the skin crease in the inside of the elbow. Surgeons attach a graft to the radius through a second incision on the outside of the arm, below the elbow. They locate the end of the original tendon and attach the graft to it with high-strength sutures. To fix the graft, surgeons may use high-strength sutures passed through tiny holes drilled in the bone or another fixation device. Both incisions are then closed with sutures.
After surgery, you wear a splint for two to four weeks to immobilize the arm, which allows your arm to heal and prevents the graft from stretching too much. You then wear a hinged elbow brace to support movement for a few weeks. If your doctor is concerned about stiffness and range of motion in your arm, they may recommend that you begin a rehabilitation program about two to four weeks after surgery.
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