2023 ISAKOS Biennial Congress ePoster
How Does Elbow Flexion Influence Supination Peak Torque In Patients With Distal Biceps Tendon Rupture?
Paolo Arrigoni, Milan ITALY
Ivan Pichierri, MD, Milan ITALY
Francesco Luceri, MD, Milano, Italy/Lombardia ITALY
Carlo Eugenio Zaolino, MD, Milan ITALY
Valerio Monteleone, MD, Milan ITALY
Enrico Rosagrata, MD, Milan ITALY
Jane Messina, MILANO (Italie) ITALY
Vincenzo Pellecchia, Cittiglio , VA ITALY
Pietro Simone Randelli, MD, Prof., Milan ITALY
ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, ITALY
FDA Status Not Applicable
Summary
Elbow flexion does not influence supination peak torque in patients with distal biceps tendon rupture
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Abstract
OBJECTIVES
Distal biceps brachi tendon (DB) ruptures are a rare event. Of all tendon injuries, DB lesions represents only 3%. The classical rupture mechanism is an eccentric load applied to a supinated and extended elbow. Some studies have quantified the reduction in supination strength with the elbow flexed at 90 °, but there is very little data regarding the loss of strength in different positions of the elbow.
Complete DB ruptures cause reduction of supination strength of the upper limb as compared to contralateral uninjured side and this change is reliably measurable in three different elbow flexion positions, with the forearm always placed in a neutral position (0 degrees of supination).
Methods
Adult patients with unilateral complete rupture of the DB and no history of previous or concomitant upper limb injuries or surgical procedures referring to a single centre between 2019 and 2020 were included in this study. The supination peak torque of both upper limbs was measured at 45 °, 90 ° and 120 ° of elbow flexion, starting from a neutral supination position (0 ° of supination).
The evaluation was performed using an isometric dynamometer. The supination strength of the injured limb was compared with that of the uninjured contralateral limb.
Results
Fifteen patients satisfying the inclusion criteria were included (males: 100%; age: 49 ± 9). The dominant limb was involved in 6 patients. The peak torque was significantly lower in the injured limb compared to the uninjured limb at all degrees of elbow flexion (P <.0001).
Conclusion
There is a significant decrease of supination strength following a complete rupture of the distal brachi biceps tendon in all degrees of elbow flexion. Elbow flexion does not influence supination peak torque either in an uninjured limb or following a rupture of the distal biceps tendon. However, supination peak torque seems to be lower when the elbow is positioned at 45° of flexion and the arm is flexed than other positions. Knowledge of strength reduction in different degrees of flexion may help the surgeon to consider a surgical treatment and to establish a correct therapeutic and rehabilitation program in order to prevent the failure of the surgical repair.