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背景 肱二头肌远端肌腱破裂虽不常见，但因前臂肌力丧失，会对患者产生显著的功能与社会心理影响。对于运动需求较高的人群，手术修复是首选治疗方案，但手术时机、切口技术与固定方式对预后的影响仍存在争议。本研究旨在英国一家三级医疗中心中对上述影响因素展开评估。 方法 本研究为回顾性观察队列研究，于2022年1月至2024年9月在北坎布里亚综合护理国民保健服务信托（North Cumbria Integrated Care NHS Trust）开展。纳入接受初次肱二头肌远端肌腱修复术且随访时长≥6个月的成年患者。收集患者的人口学资料、手术时机、切口类型、固定方式、并发症情况以及功能评分数据。采用描述性统计、卡方检验/费希尔精确检验以及校正混杂因素的回归模型对结局指标进行分析。 结果 本研究共纳入50例患者，患者年龄主要集中在31~50岁区间。多数修复手术在伤后3周内完成（76%），采用单切口入路（82%）与缝线纽扣固定（suture button fixation）。56%的患者出现并发症，最常见的为前臂外侧皮神经（lateral antebrachial cutaneous nerve，LABC）麻木（42%）。严重并发症发生率较低：肌腱再断裂（2%）、固定失效（2%）、切口感染（4%）以及切口裂开（2%）。35例患者获得功能结局数据，其功能评分均值为8.64±13.37。不同手术时机（p=0.448）与不同固定方式（p=0.408）的患者，其功能评分均无显著差异。早期手术与延期手术患者的并发症发生率无显著差异（p=0.119），单切口与双切口术式患者的并发症发生率亦无显著差异（p=0.225）。 结论 本英国医疗中心开展的肱二头肌远端肌腱修复术，无论手术时机、切口方式或固定类型如何，均具有较低的严重并发症发生率与良好的术后恢复效果。前臂外侧皮神经相关症状较为常见。