Name of the Procedure:

Reinsertion of Ruptured Biceps or Triceps Tendon, Distal, With or Without Tendon Graft

Summary

This surgical procedure involves reattaching a ruptured biceps or triceps tendon at the distal end (near the elbow). In some cases, a tendon graft may be used to ensure proper healing.

Purpose

This procedure addresses tendon ruptures in the biceps or triceps, often due to trauma or heavy lifting. The goal is to restore the normal function and strength of the injured tendon and allow the patient to regain full range of motion in the affected arm.

Indications

• Sudden, sharp pain in the elbow followed by arm weakness
• Noticeable bulge in the upper arm due to muscle retraction
• Inability to bend (biceps) or straighten (triceps) the elbow
• MRI or ultrasound confirmation of tendon rupture

Preparation

• Fasting for 8-12 hours before the procedure
• Adjusting or stopping certain medications as advised by the healthcare provider
• Pre-operative imaging studies such as MRI or ultrasound
• Routine blood tests and a physical exam

Procedure Description

1. The patient is given regional or general anesthesia.
2. An incision is made near the elbow to access the ruptured tendon.
3. The tendon ends are identified and prepared for reattachment.
4. If needed, a tendon graft from another part of the body or a donor is inserted to assist in reconstruction.
5. The tendon is securely reattached to the bone using sutures, anchors, or screws.
6. The incision is closed with stitches, and a sterile dressing is applied.

Duration

Typically, 1 to 2 hours.

Setting

Performed in a hospital or surgical center, often as an outpatient procedure.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist
• Surgical technologist

Risks and Complications

• Infection
• Bleeding or hematoma
• Nerve damage
• Stiffness or reduced range of motion
• Tendon re-rupture
• Adverse reaction to anesthesia

Benefits

• Restoration of arm strength and function
• Relief from pain and discomfort
• Ability to return to normal activities and sports

Recovery

• Wearing a splint or brace for several weeks to protect the repair
• Physical therapy to regain strength and mobility
• Follow-up appointments to monitor healing
• Full recovery may take 3 to 6 months, with some restrictions on heavy lifting and strenuous activities

Alternatives

• Non-surgical management with physical therapy and bracing (may not be suitable for complete ruptures)
• Other surgical techniques tailored to the patient's needs
• The pros include avoiding surgery, while the cons may be incomplete healing or persistent weakness

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Postoperative pain and swelling are managed with pain relievers and ice packs. The patient may experience some discomfort and restrictions on arm movements during the initial recovery period. Physical therapy plays a crucial role in rehabilitation and achieving a full functional recovery.