This cadaveric study maps the osteology of the bicipital tuberosity and the distal biceps tendon insertion footprint. It combines 178 dried radii, CT imaging of 48 specimens, and dissection of 18 fresh elbows. The goal is to guide distal biceps repair and proximal radius reconstruction.
When you repair a distal biceps rupture, the target is the ulnar aspect of the tuberosity, not the ridge or the center of the bone. This paper defines that footprint precisely: a narrow ribbon covering about 63% of tuberosity length and only 13% of its width. Knowing this shapes where you place your bone tunnel, anchor, or cortical button.
The authors frame a mechanistic model for rupture. A prominent tuberosity edge erodes the tendon during rotation, and the interosseous space narrows about 50% in pronation, both stressing the tendon under load.
The ridge acts as a pulley to boost biceps mechanical advantage, which is the anatomic argument for restoring the tendon to its native footprint rather than simply burying a shortened tendon in a trough.
The CT cortical thicknesses (roughly 13 mm to one cortex, 15 mm bicortical) and the radial head diameter of about 23 mm are practical reference numbers for fixation depth and radial head implant sizing.
This cadaveric study maps the osteology of the bicipital tuberosity and the distal biceps tendon insertion footprint. It combines 178 dried radii, CT imaging of 48 specimens, and dissection of 18 fresh elbows. The goal is to guide distal biceps repair and proximal radius reconstruction.
When you repair a distal biceps rupture, the target is the ulnar aspect of the tuberosity, not the ridge or the center of the bone. This paper defines that footprint precisely: a narrow ribbon covering about 63% of tuberosity length and only 13% of its width. Knowing this shapes where you place your bone tunnel, anchor, or cortical button.
The authors frame a mechanistic model for rupture. A prominent tuberosity edge erodes the tendon during rotation, and the interosseous space narrows about 50% in pronation, both stressing the tendon under load.
The ridge acts as a pulley to boost biceps mechanical advantage, which is the anatomic argument for restoring the tendon to its native footprint rather than simply burying a shortened tendon in a trough.
The CT cortical thicknesses (roughly 13 mm to one cortex, 15 mm bicortical) and the radial head diameter of about 23 mm are practical reference numbers for fixation depth and radial head implant sizing.