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Review paper
Published: 09.10.2020. Biochemistry
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https://doi.org/10.17392/1303-21

Distal biceps tendon repair and posterior interosseous nerve injury: clinical results and a systematic review of the literature

By
Silvio Chiossi Orcid logo ,
Silvio Chiossi
Contact Silvio Chiossi

Orthopedics and Traumatology Unit, Department of Emergency and Acceptance, San Camillo - Forlanini Hospital Rome, Rome, Italy

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Marco Spoliti ,
Marco Spoliti

Orthopedics and Traumatology Unit, Department of Emergency and Acceptance, San Camillo - Forlanini Hospital Rome, Rome, Italy

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Pasquale Sessa ,
Pasquale Sessa

Orthopedics and Traumatology Unit, Department of Emergency and Acceptance, San Camillo - Forlanini Hospital Rome, Rome, Italy

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Valerio Arceri ,
Valerio Arceri

Orthopedics and Traumatology Unit, Department of Emergency and Acceptance, San Camillo - Forlanini Hospital Rome, Rome, Italy

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Attilio Basile ,
Attilio Basile

Orthopedics and Traumatology Unit, Department of Emergency and Acceptance, San Camillo - Forlanini Hospital Rome, Rome, Italy

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Francesca Romana Rossetti ,
Francesca Romana Rossetti

Orthopedics and Traumatology Unit, Department of Emergency and Acceptance, San Camillo - Forlanini Hospital Rome, Rome, Italy

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Riccardo Maria Lanzetti
Riccardo Maria Lanzetti

Orthopedics and Traumatology Unit, Department of Emergency and Acceptance, San Camillo - Forlanini Hospital Rome, Rome, Italy

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Abstract

Aim
To report clinical, functional and radiographic results of oneincision distal biceps tendon repair with Toggle Loc (Zimmer-Biomet, Warsaw, Indiana, USA) at an average 4-year follow-up and to assess posterior interosseous nerve injury complications after reconstruction.
Methods
We conducted a retrospective review of 58 consecutive distal biceps tendon repairs performed at our department between
2010 and 2018. Disabilities of Arm, Shoulder and Hand (DASH) score, Visual Analogue Scale (VAS) scale and elbow range of motion (ROM) were recorded at each follow-up and an ultrasound examination was also performed to assess the repaired biceps brachii tendon.
Results
Clinical evaluation showed good and excellent results at medium- and long-term follow-up. A temporary posterior interosseous nerve (PIN) palsy developed in four (6.81%) patients and always resolved in 8 weeks. PIN palsy prevalence is in accordance with the results of the previous studies.
Conclusion
Distal biceps tendon repair with Toggle Loc is an effective surgical procedure. PIN injury is a relatively rare complication after one-incision anterior repair. Our complication rate did not differ significantly from other studies that have used cortical
button fixation, reported in current literature. Our results confirm that accidental injury of PIN may also happen to experienced surgeons and suggest extreme care and an appropriate surgical technique to reduce this iatrogenic risk. 

Keywords:

radial nerve lesion,
surgical repair,
sport trauma,
tendon avulsion

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