Bain (2000) describes a single-incision distal biceps tendon repair using the Endobutton — a titanium cortical button borrowed from ACL reconstruction — to deliver and lock the tendon into the medullary canal of the radial tuberosity. The study reports clinical outcomes in 12 patients and uses cadaveric dissection to map neurovascular distances and quantify the safety margin of the transradial drilling technique.
When repairing a distal biceps avulsion with a cortical button technique, keep the forearm in full supination and direct the transradial drill straight posterior — cadaveric data show this maintains a ~14 mm margin to the PIN, while any posterolateral angulation nearly halves that distance and risks nerve injury.
The 'prefabrication' principle. Suturing the tendon to the button outside the wound before delivery. Remains a core feature of modern single-incision cortical button repairs.
Bain (2000) describes a single-incision distal biceps tendon repair using the Endobutton — a titanium cortical button borrowed from ACL reconstruction — to deliver and lock the tendon into the medullary canal of the radial tuberosity. The study reports clinical outcomes in 12 patients and uses cadaveric dissection to map neurovascular distances and quantify the safety margin of the transradial drilling technique.
When repairing a distal biceps avulsion with a cortical button technique, keep the forearm in full supination and direct the transradial drill straight posterior — cadaveric data show this maintains a ~14 mm margin to the PIN, while any posterolateral angulation nearly halves that distance and risks nerve injury.
The 'prefabrication' principle. Suturing the tendon to the button outside the wound before delivery. Remains a core feature of modern single-incision cortical button repairs.