SUMMARY
Background. Distal biceps brachii tendon ruptures occur rarely accounting for 3% of all biceps tendon injuries. This systematic review aims to assess the outcomes of both operative and non-operative management of distal biceps brachii tendon rupture for adult patients. The literature has mostly advocated that surgical intervention to be the best management of such injuries however in recent times studies have shown acceptable outcomes of non-operative treatment in those affected and therefore offer an alternative to current practise.
Methods. The NICE Healthcare Databases Advanced Search (HDAS) tool was used to identify articles in the PubMed, Medline, EMBASE, and the Cochrane Central Register of Controlled Trials databases to identify articles relating to distal biceps brachii tendon rupture management. The search strategy was formed by using the set key words. Studies published from 1998-2008 were included. Functional outcome questionnaires and isometric strength tests were used. An inclusion criterion identified articles to be critically appraised.
Results. Initially 427 papers were identified with the key words in the search approach from the use of the electronic databases. 294 papers were excluded because they were either duplicates or unrelated to distal rupture of the tendon biceps brachii. It recognized 17 papers and abstracts of which 11 were omitted because they were either in a different language or were case reports.
Conclusions. This review highlights that the current evidence for surgical management of distal biceps brachii tendon rupture is weak. Studies in recent times have mostly focused on the different methods of surgical fixation. We noted that surgical fixation resulted in a large number of complications, which if communicated to the patient may result in them opting for conservative management.
However equally important to highlight is that patients who are middle-aged, with a modest physical demand should be made aware that if treated non-operatively they may likely have good to excellent functional outcome as well as having approximately 50% strength in the flexed and supinated position of the injured arm, whilst avoiding the potential complications of surgery. This review also highlights that more higher quality evidence is required in future.
Operative Versus Non-Operative Management of Distal Biceps Brachii Tendon Rupture: A Systematic Review
M. K. Qureshi, A. S. Khaled, A. O. Elgindi, S. Mastan, M. Jeyam
Review, 678-685
Keywords: Distal biceps brachii tendon ruptur; distal biceps tendon rupture; surgical treatment; conservative treatment; systematic review,
Table of Content: Vol. 10 (No.4) 2020 October/December
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