A retrospective review of 74 primary distal biceps tendon repairs done through the muscle-splitting modification of the two-incision (Boyd-Anderson) technique at the Mayo Clinic from 1981 to 1998. The study catalogs the full complication profile and asks whether repair timing, surgical exposure, and surgeon experience affect outcomes.
Repair a complete distal biceps avulsion early, ideally within 10 days, and keep the anterior incision small.
This paper links the two big complications, sensory nerve paresthesia and anterior elbow pain, directly to the long Henry incision. A small transverse antecubital incision produced neither. When you must go anterior, protect the lateral antebrachial cutaneous and superficial radial nerves, and remember the PIN is at risk with any dissection near the radial tuberosity.
The headline safety point is that the muscle-splitting modification, which stays out of the subperiosteal ulnar plane and irrigates out bone dust, produced no synostoses in 74 cases. The historical fear of synostosis with two-incision repair is real but preventable with technique.
Timing also drives the graft decision. Past two to three months the tunnel obliterates and the tendon retracts, so plan for graft augmentation and counsel the patient accordingly.
A retrospective review of 74 primary distal biceps tendon repairs done through the muscle-splitting modification of the two-incision (Boyd-Anderson) technique at the Mayo Clinic from 1981 to 1998. The study catalogs the full complication profile and asks whether repair timing, surgical exposure, and surgeon experience affect outcomes.
Repair a complete distal biceps avulsion early, ideally within 10 days, and keep the anterior incision small.
This paper links the two big complications, sensory nerve paresthesia and anterior elbow pain, directly to the long Henry incision. A small transverse antecubital incision produced neither. When you must go anterior, protect the lateral antebrachial cutaneous and superficial radial nerves, and remember the PIN is at risk with any dissection near the radial tuberosity.
The headline safety point is that the muscle-splitting modification, which stays out of the subperiosteal ulnar plane and irrigates out bone dust, produced no synostoses in 74 cases. The historical fear of synostosis with two-incision repair is real but preventable with technique.
Timing also drives the graft decision. Past two to three months the tunnel obliterates and the tendon retracts, so plan for graft augmentation and counsel the patient accordingly.