Cortical Button Fixation Procedure: A Case Study

Distal biceps tendon ruptures remain a rare injury, but over the last decade the number of incidences has increased. However, it still only accounts for 3-10 % of all bicep tendon ruptures. Due to the rarity of injury, the diagnosis is often delayed leading to significant loss of elbow ROM and more importantly decreases in forearm supination and elbow flexion strength. Early detection and therapy of the distal biceps tendon is key for obtaining the best functional outcome for these patients. After detecting the ruptured distal biceps tendon, the fixation process can be performed by several techniques with an overall good functional and clinical outcome [1,2]. However, clinical outcome studies that evaluate the effectiveness of these refixation techniques are scarce. As future evidence based clinicians it is our responsibility to stay on top of the latest research so that we may provide the most optimal treatment for our patients.
One of the main issues associated within all 5 case studies was a small sample size. These studies consisted of a minimal of 3 patients to a maximal of 22 patients selected to participate. On the other hand, patients evaluated regained full elbow ROM and good clinical outcomes in terms of strength in flexion and supination. Ruptures are most commonly seen in the dominant elbow of men who are in the fourth decade of life. Therefor must participants selected in these studies were over the age of 40 and primarily men, yet women were also included in the criteria as traumatic distal biceps tendon ruptures can occur in the female population