Hand and Upper Extremity Unit, Hospital Fremap, Majadahonda, Madrid, Spain

Purpose: Distal biceps tendon chronic tears are an infrequent presentation. Tendon stump retraction and degeneration often prevents direct repair. We describe a method of reconstruction with Achilles tendon allograft and present our results.

Material and Methods: An Achilles tendon allograft was used to reconstruct a chronic rupture (>3 months post-rupture) of the distal biceps tendon in 3 patients. We used amodified 2-incision techniqueand distal attachment using two biodegradable anchors (Panaloc© Mitek, Norwood, MA). Outcome assessment included range of motion, pain, strength, return to work, workers´ compensation (Spanish board) and the Mayo Elbow Performance Score (MEPS) at the end of follow-up.

Results: After an average duration of prospective follow-up of 29 months (range, 20 to 42 years), all patients had a satisfactory subjective result, a full range of motion, and an excellent Mayo elbow performance score. Similar elbow flexion and forearm supination strength when compared to the contralateral side. All patients returned to their previous job within 14 weeks from surgery. There was one case of Posterior Interosseous Nerve transient palsy which fully recovered within 3 months with conservative management. No second procedures were needed.

Conclusion: Distal biceps tendon chronic tear reconstruction with Achilles tendon allograft using a modification of the two-incision technique is a safe and valid treatment option in high functional demand patients. Larger series and longer follow up are required to confirm our results.