BALTIMORE — Researchers found high complication rates associated with distal biceps tendon tears repaired with a single-incision technique, according to study results presented at the American Orthopaedic Society for Sports Medicine Annual Meeting 2012, here.
“Our overall complication rate was 58% with most common complication being transient sensory nerve dysfunction,” presenter Leslie Bisson, MD, said. “These tend to resolve in 6 to 9 months in all the patients we could verify and there is no association of complications with tourniquet use or hardware. Workers’ compensation, although it had a higher percentage of complications, was not statistically significant. We did find fewer complications when the surgery was performed within the first 2 weeks of injury.”
Bisson and colleagues studied 67 men who consecutively underwent distal biceps repairs using a single-incision anterior approach between 2003 and 2010. The average follow-up was 5 months and average patient age was 46 years. Twenty-nine patients had surgery within 2 weeks of injury, 22 patients underwent repair within 2 weeks to 6 weeks and 16 patients had surgery more than 6 weeks post- injury.
The investigators used the Chi squared test to compare complications by time to surgery, surgeon, hardware used, tourniquet use, and workers’ compensation cases.
They calculated a 58% complication rate, with transient nerve dysfunction, infection, loss of motion, rerupture or hardware problems among the complications noted. Among the seven workers’ compensation patients, there was an 86% complication rate, but this was not significant, Bisson said. The patients who underwent surgery within 2 weeks of injury showed lower complication rates than patients who underwent repair 2 weeks after injury. The tourniquet time, hardware type and longitudinal transverse incision were not significant factors of complications.
“Outcome studies of single-incision repairs have had complications ranging from 8% to 44% with the majority of these being sensory and nerve dysfunction,” Bisson said. “But there has been no study that has specifically focused on complications.”
Reference:
Bisson L, Gawai YV, Fineberg MS, et al. Complications associated with single-incision distal biceps tendon repair. Paper #13. Presented at the American Orthopaedic Society for Sports Medicine Annual Meeting 2012. July 12-15. Baltimore.
