The biceps tendon inserts into a bony prominence (radial tuberosity) at the elbow end of one of the forearm bone (called the radius).
The distal biceps tendon effects flexion of the elbow as well as supination of the forearm (turning the screwdriver).
This tendon can rupture off the bony attachment at the radial tuberosity. This is a rare injury.
It usually occurs in the dominant elbow of men in their forties. It is more common in smokers or people taking anabolic steroids.
The patient usually recalls a painful “pop” or “snap” from the elbow when the forearm was extended with biceps muscle in contraction. This will lead to pain, swelling, weakness of elbow flexion and forearm supination.
Surgery to repair the distal biceps tendon back to the bone (radial tuberosity) should be done to restore elbow flexion and forearm supination strength.
I prefer a cortical button fixation technique which provides a strong anatomical repair with early mobilisation of the operated elbow.