Beyond The Cut- The Cumberland Experience In Timing,Technique And Outcomes Of Distal Biceps Tendon Repair

BackgroundDistal biceps tendon rupture, though uncommon, has significant functional and psychosocial consequences due to loss of forearm strength. Surgical repair is the treatment of choice for active individuals, yet the influence of surgical timing, incision technique, and fixation type on outcomes remains debated. This study aimed to evaluate these factors in a UK tertiary centre.MethodsA retrospective observational cohort study was conducted at North Cumbria Integrated Care NHS Trust between January 2022 and September 2024. Adults undergoing primary distal biceps tendon repair with ≥6 months of follow-up were included. Data were collected on demographics, timing of surgery, incision type, fixation method, complications, and functional scores. Outcomes were analysed using descriptive statistics, chi-square/Fisher’s exact tests, and regression models adjusting for confounders.ResultsFifty patients were included (mean age predominantly 31–50 years). Most repairs were performed within 3 weeks (76%), using a single-incision approach (82%) and suture button fixation (68%). Complications occurred in 56% of patients, most commonly lateral antebrachial cutaneous (LABC) nerve numbness (42%). Major complications were infrequent: rerupture (2%), fixation failure (2%), wound infection (4%), and wound gaping (2%). Functional outcomes were available for 35 patients (mean 8.64 ± 13.37). No significant differences were observed in functional scores by timing of surgery (p = 0.448) or fixation type (p = 0.408). Complication rates did not differ significantly between early and delayed surgery (p = 0.119) or between single- and dual-incision approaches (p = 0.225).ConclusionDistal biceps tendon repair at this UK centre was associated with low rates of major complications and satisfactory recovery, irrespective of timing, incision, or fixation type. LABC nerve symptoms were common