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New Insights in Diagnosis and Treatment of Distal Biceps Pathology

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ESSKA Instructional Course Lecture Book

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Abstract

Biceps brachii is composed of two separate heads and is innervated by a branch of the musculocutaneous nerve [1]. The proximal tendon of the long head is attached to the supraglenoid tubercle, and the proximal tendon of the short head is attached to the coracoid process. The biceps (muscle and tendon) rotates 90° externally from origin to insertion onto the bicipital tuberosity [2] and acts on three joints: the glenohumeral, ulnohumeral, and proximal radioulnar joints. A completely bifurcated distal tendon insertion is not uncommon [3, 4]. The short head of the distal biceps tendon was reported to insert more distally, and the long head was inserted more eccentric and medial. The moment arm of the long head was higher in supination, and the short head had a higher moment arm in neutral position and pronation [5]. These findings may allow functional independence and isolated rupture of each portion and may have consequences for restoring the native anatomy during a surgical repair. Several authors reported an isolated rupture of one of the two tendons in cases of bifurcated distal biceps tendons [4].

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Amphia Hospital and University of Amsterdam, Amsterdam, The Netherlands

    Denise Eygendaal

  2. Department of Orthopedic Surgery, OLVG, Amsterdam, The Netherlands

    Michel van den Bekerom

  3. Department of Orthopedic Surgery, University Hospital La Paz, Madrid, Spain

    Raul Barco

  4. Department of Orthopedic Surgery, Universtiy of Milano, Milan, Italy

    Paolo Arrigoni, Riccardo D’Ambrosi, Davide Cucchi, Simone Nicoletti & Pietro Simone Randelli

  5. Department of Orthopedic Surgery, University of Cologne, Cologne, Germany

    Kilian Wegmann & Lars Peter Müller

Authors
  1. Denise Eygendaal
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  2. Michel van den Bekerom
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  3. Raul Barco
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  4. Paolo Arrigoni
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  5. Riccardo D’Ambrosi
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  6. Davide Cucchi
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  7. Simone Nicoletti
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  8. Pietro Simone Randelli
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  9. Kilian Wegmann
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  10. Lars Peter Müller
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Corresponding author

Correspondence to Denise Eygendaal .

Editor information

Editors and Affiliations

  1. Orthopaedic Surgery, Academic Medical Center, AZ Amsterdam, The Netherlands

    Gino M. M. J. Kerkhoffs

  2. Orthopaedics and Trauma, University College London Hospitals, London, UK

    Fares Haddad

  3. Kantonsspital Baselland , Bruderholz, Switzerland

    Michael T. Hirschmann

  4. Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden

    Jón Karlsson

  5. Clinique d’Eich, Centre Hospitalier de Luxembourg Clinique d’Eich, Luxembourg, Luxembourg

    Romain Seil

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Eygendaal, D. et al. (2018). New Insights in Diagnosis and Treatment of Distal Biceps Pathology. In: Kerkhoffs, G.M.M.J., Haddad, F., Hirschmann, M.T., Karlsson, J., Seil, R. (eds) ESSKA Instructional Course Lecture Book. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56127-0_7

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  • DOI: https://doi.org/10.1007/978-3-662-56127-0_7

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-56126-3

  • Online ISBN: 978-3-662-56127-0

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