Distal biceps rupture

Distal biceps rupture

Elbow ​Condition

Distal biceps rupture

Tears of the biceps tendon at the elbow are uncommon. They are most often caused by a sudden injury and tend to result in greater arm weakness than injuries to the biceps tendon at the shoulder.

Anatomy

The biceps muscle has two tendons that attach the muscle to the shoulder and one tendon that attaches at the elbow. The tendon at the elbow is called the distal biceps tendon. It attaches to a part of the radius bone called the radial tuberosity, a small bump on the bone near your elbow joint.

Causes

The main cause of a distal biceps tendon tear is a sudden injury. These tears are rarely associated with other medical conditions.

Injuries to the biceps tendon at the elbow usually occur when the elbow is forced straight against resistance. It is less common to injure this tendon when the elbow is forcibly bent against a heavy load.

Risk Factors

Men, age 30 years or older, are most likely to tear the distal biceps tendon.

Additional risk factors for distal biceps tendon tear include:

  • Smoking.
  • Corticosteroid medications.
Symptoms

There is often a “pop” at the elbow when the tendon ruptures. Pain is severe at first, but may subside after a week or two. Other symptoms include:

  • Swelling in the front of the elbow
  • Visible bruising in the elbow and forearm
  • Weakness in bending of the elbow
  • Weakness in twisting the forearm (supination)
  • A bulge in the upper part of the arm created by the recoiled, shortened biceps muscle
  • A gap in the front of the elbow created by the absence of the tendon
Treatment

Surgery to reattach the tendon to the bone is necessary to regain full arm strength and function.

Nonsurgical treatment may be considered if you are older and less active, or if the injury occurred in your nondominant arm and you can tolerate not having full arm function. Nonsurgical treatment may also be an option for people who have medical problems that put them at higher risk for complications during surgery.