It’s unusual for a distal biceps avulsion to involve a substantial piece of bone. In any case, the treatment would focus on the distal biceps avulsion and the person’s motivation for strong supination. Fixation of the fragment is not as important as reattachment of the tendon.
|Patients who tolerate 40% loss of supination strength. Nondisplaced fractures.|
Note: Nonoperative treatment is generally only indicated if functional forearm rotation can be demonstrated with or without anesthetic injection.
- Fragment of bone restricting forearm rotation
- Infirm or dependent person
- Avoid the risks of surgery.
- Weaker supination
|Displaced fracture and desire for optimal supination strength|
- Infirm or inactive patient
- Poor soft-tissue condition
- Stronger supination
- Risk of radial nerve injury
- Risk of radioulnar synostosis
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|