Distal Biceps Tendon Tear

A distal biceps tendon tear is a rupture of the tendon attaching the biceps muscle to the forearm bone at the elbow, usually caused by a sudden forceful load.

Sudden pain in the front of the elbow, often with a pop, followed by bruising, swelling, weakness with forearm rotation and elbow bending, and a visible change in the muscle contour ("Popeye" deformity).

Typically occurs from a sudden eccentric load on a flexed elbow, such as trying to catch a heavy falling object.

Seek prompt assessment after a sudden elbow injury with pain, weakness, or a visible change in the biceps contour, as early repair gives the best results.

Clinical examination assessing the biceps contour, tenderness, and strength of elbow flexion and forearm rotation.

MRI confirms the tear and helps plan surgical repair.

Non-operative treatment may be appropriate for lower-demand patients or partial tears, accepting some loss of strength.

Surgery is generally recommended for complete tears in active individuals, ideally within a few weeks of injury.

Surgical repair reattaches the tendon to the forearm bone using anchors or a button-and-tunnel technique.

A period of splinting or bracing is followed by progressive hand therapy; full recovery of strength typically takes four to six months.

Surgical repair generally restores good strength and function, especially when performed early after injury.

Nerve irritation, stiffness, re-rupture, and heterotopic bone formation are recognized but uncommon complications.