Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Distal Biceps Tendon Rupture

SYMPTOMS

There is acute pain in the elbow and sudden weakness in elbow flexion.

AETIOLOGY

This is an acute injury, where the tendon usually ruptures close to the distal insertion at the radius during an excessive elbow extension or flexion manoeuvre.

CLINICAL FINDINGS

Pain and weakness is provoked by resisting elbow flexion. There is often significant swelling, bruising and/or haemarthrosis.

INVESTIGATIONS

X-ray should be taken, to rule out fracture of the elbow. MRI verifies the diagnosis.

TREATMENT

A complete tear of the biceps tendon at this site usually requires surgical re-fixation in physically active people. A partial tear may be
treated with partial immobilisation, since surgery can be performed later if healing does not occur.

REFERRALS

Refer to Dr Kevin Yip (+65 9724 1219) senior consultant orthopaedic surgeon if this diagnosis is suspected or if the diagnosis is not clear.

EXERCISE PRESCRIPTION

Many sports can be maintained during healing but the inability to exert force from elbow flexion rules out most racket sports if the dominant arm is affected. After surgery most activities can be back to normal within 12 weeks. Running and cycling (when the wound is healed after surgery) are good alternatives to keep up general fitness. Gym training can be maintained.

EVALUATION OF TREATMENT OUTCOMES

Normal clinical symptoms and signs and good elbow function, including strength and flexibility. Compare with other elbow.

DIFFERENTIAL DIAGNOSES

This is a clinical diagnosis, verified by MRI, but fractures must be suspected.

PROGNOSIS

Excellent, if treated appropriately.

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