Back to Annual Meeting Posters

Hypothesis: The incidence of bilateral distal biceps tendon ruptures is greater than the incidence of isolated distal biceps tendon ruptures.

Methods: A retrospective review of the personal database of distal biceps tendon repairs performed by a single surgeon at a single institution identified 321 patients who underwent operative repair of a distal biceps tendon rupture between 1988 and 2010. Twenty-six patients had bilateral ruptures. Demographics, including the patient age, the mechanism of injury, the time between symptom onset before the first surgery as well as the time between contralateral symptom onset and the contralateral surgery, and the time between surgeries was recorded.

Results: The cumulative incidence of bilateral distal biceps tendon ruptures was 7.8%. Twenty-four of the 26 bilateral tendon ruptures occurred in men, 2 occurred in women representing a frequency of 92% in men and 8% in women. The average age at the initial rupture was 44 years (range 29-74 years). The average age at subsequent rupture was 48 years (range 36-79 years). Excluding the two female patients (age 72 years and 79 years), the average age at the initial rupture was 42 years and the average age at subsequent rupture was 46 years. The average interval between ruptures was 4.1 years (range of 0.8 to 13.9 years). The initial rupture occurred in the dominant extremity in 48% of the cases and in the non-dominant extremity in 40% of the cases. Of the patients that sustained bilateral tendon ruptures, 33% were heavy laborers. Less than 2% had a smoking history, and less than 2% reported using any type of steroid. Eight-five percent of the patients who had a subsequent tendon rupture underwent operative re-attachment. Intraoperative evaluation established that 55% of the subsequent tendon ruptures were partial tears.

Summary Points:

1. The reported incidence of a distal biceps tendon rupture is 1.2/100,000.

2. In our series, the incidence of a contralateral distal biceps tendon rupture is 7.8%, demonstrating a significant increased risk for sustaining a subsequent distal biceps tendon rupture.

3. The true incidence is probably higher as our series does not reflect those patients who were asymptomatic and those patients who went elsewhere for treatment.

4. The higher incidence of patients with bilateral distal biceps tendon ruptures is significant and suggests that bilateral distal biceps tendon ruptures may be due to an underlying systemic factor.