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Functional impacts of the endobutton technique in distal biceps tendon repair
Maryam, Nuha Ashwood, Neil Morris, Daniel Dekker, Andrew Ishaq, Aiman Danyowi, Saud
Maryam, Nuha
Ashwood, Neil
Morris, Daniel
Dekker, Andrew
Ishaq, Aiman
Danyowi, Saud
Abstract
Background: Distal biceps tendon rupture is an uncommon injury that can result in significant impairment of elbow flexion and forearm supination. Surgical repair is commonly recommended for active patients, with a range of fixation techniques described. While bicortical Endobutton fixation (BEF) has demonstrated favourable biomechanical properties, clinical data describing functional recovery over time remain limited. Methods: This retrospective case series evaluated ten patients who underwent distal biceps tendon repair (DBTR) using a single-incision anterior approach with BEF. Isometric elbow flexion and radioulnar supination strength were assessed at 3 and 12 months post-operatively using a dynamometer and compared with the contralateral, uninjured limb. Post-operative complications were recorded. Results: At three months post-operation, both flexion and supination strength of the repaired limb were significantly reduced compared with the contralateral limb. By 12 months, flexion strength demonstrated substantial recovery and was no longer significantly different from the control limb, whereas supination strength remained significantly reduced. Mean flexion strength relative to the contralateral limb improved from 68.34% to 92.77% between 3 and 12 months, while mean supination strength improved from 48.81% to 69.89%. Two (20%) patients experienced transient neuropraxia, with no tendon re-ruptures observed. Conclusion: DBTR using a BEF technique resulted in progressive functional recovery over 12 months. Elbow flexion strength demonstrated substantial recovery within the first post-operative year, while recovery of forearm supination strength was slower and less complete. These findings may assist with rehabilitation planning and patient counselling regarding expected functional outcomes following this technique.
Affiliations
University Hospitals of Derby and Burton NHS Foundation Trust
Date
2026-05-14
Type
Article
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(12) Cureus.pdf
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Citation
Maryam N, Ashwood N, Morris D, et al. (May 14, 2026) Functional Impacts of the Endobutton Technique in Distal Biceps Tendon Repair. Cureus 18(5): e108849. doi:10.7759/cureus.108849
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Maryam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0.,which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.