Distal Biceps Tendon Repair in San Antonio, TX
What Is a Distal Biceps Tendon Rupture?
The distal biceps tendon attaches the biceps muscle to the radial tuberosity at the elbow. When it ruptures — usually from a forceful eccentric load like catching a heavy object or a missed lift — the muscle belly bunches up toward the shoulder, supination strength drops significantly and a characteristic bruising pattern appears in the antecubital fossa. Most patients describe a sharp pop followed by immediate weakness.
This is an injury that rewards prompt surgical attention. Acute repair within the first two to three weeks is technically straightforward and produces excellent functional outcomes. Delayed repair after three to four weeks involves muscle retraction, scarring and a much more demanding surgical dissection with less predictable results.
Do You Need Surgery?
If you are an active individual who uses your arm for physical work, sport or overhead activity, surgical repair is almost always the right decision. The functional deficit without repair — particularly in forearm supination and elbow flexion strength — is meaningful and permanent. Older, sedentary patients are the primary population for whom non-operative management is a reasonable discussion.
Surgical Technique
I perform distal biceps repair using a single-incision technique with cortical button fixation in most cases. The button passes through a tunnel drilled in the radial tuberosity, providing strong anatomic fixation at the native attachment site. I prefer this technique for its security, anatomic positioning and early mobilization potential. In cases with significant retraction or scarring from delayed presentation, a two-incision approach may be necessary to safely retrieve the tendon.
Recovery
- Weeks 1 to 2: Splint, gentle passive elbow flexion-extension
- Weeks 2 to 6: Progressive active motion, avoid heavy supination loading
- Months 2 to 3: Progressive strengthening, most daily activities
- Month 4 to 6: Full return to heavy labor, lifting and sport
Strength recovery after distal biceps repair is excellent in appropriately timed cases. Most patients recover to near-normal supination and flexion strength by 4 to 6 months. The window for an acute repair is short — if you have recently sustained this injury, prompt evaluation is important.
Ready to take the next step? Call (210) 878-4113 or request an appointment at sportssurgeryspecialist.com.
