Distal biceps tendon repair is an operation to reattach the biceps tendon to the radius bone at the elbow. Rupture typically occurs during a sudden lifting or pulling injury and results in loss of elbow flexion and forearm rotation strength.
An incision is made over the front of the elbow. The ruptured tendon end is retrieved and prepared. A fixation device (such as a button, anchor, or interference screw) is used to reattach the tendon to the radius bone. The operation takes approximately one hour.
Surgery is recommended for active patients who wish to restore full elbow and forearm strength. Without repair, there is approximately 30–40% loss of forearm supination strength (turning the palm upward) and approximately 30% loss of elbow flexion strength.
Non-operative management is an option for less active patients or those with significant medical risks. The arm remains functional but with reduced strength for heavy lifting and rotation.
Surgery is ideally performed within two to three weeks of injury, before the tendon retracts and scarring makes repair more difficult. MRI or ultrasound confirms the diagnosis.
Restoration of elbow flexion and forearm rotation strength to near-normal levels. Most patients return to full activity including manual work and sport.
Visible scar on the front of the elbow.
Lateral cutaneous nerve of the forearm may be stretched, causing temporary forearm numbness.
Temporary loss of full elbow extension.
Bone formation in the soft tissues around the elbow, potentially limiting rotation. Risk approximately 5%.
The repair may fail, particularly if loaded too early. Risk approximately 2–5%.
Temporary weakness of finger extension. Usually recovers.
Wound infection.
Very rare fusion of the radius and ulna bones, severely limiting rotation.
General or regional arm block anaesthesia.
A hinged elbow brace is worn for six weeks. Gentle movement begins immediately within protected limits. Strengthening starts at three months. Return to manual work at three to four months. Return to sport at four to six months. Full recovery at six months.
Reviews at two weeks, six weeks, and three months.
The arm remains functional but with approximately 30–40% loss of forearm rotation strength and 30% loss of elbow flexion strength. This is noticeable with heavy lifting and manual work.
Distal biceps ruptures typically occur when a heavy load is lifted with the elbow bent, creating a sudden force on the tendon. They are more common in men aged 30–60.