Executive Editor: Peter Trafton, Michael Baumgaertner

Authors: Peter Kloen, David Ring

Proximal forearm Radius, extraarticular, avulsion of bicipital tuberosity

back to skeleton

Glossary

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.

Nonoperative
Indication summary Skill Equipment
Patients who tolerate 40% loss of supination strength. Nondisplaced fractures. Basic surgical experience, no specialized skills Basic equipment only

Note: Nonoperative treatment is generally only indicated if functional forearm rotation can be demonstrated with or without anesthetic injection.

Contraindication

  • Fragment of bone restricting forearm rotation
  • Infirm or dependent person
  • Polytrauma

Advantages

  • Avoid the risks of surgery.

Disadvantages

  • Weaker supination
Biceps reinsertion
Indication summary Skill Equipment
Displaced fracture and desire for optimal supination strength Highly experienced and skilled surgeon Simple surgical and imaging resources

Contraindications

  • Infirm or inactive patient
  • Poor soft-tissue condition

Advantages

  • Stronger supination

Disadvantages

  • Risk of radial nerve injury
  • Risk of radioulnar synostosis
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v2.0 2018-04-30