Distal Biceps surgery?

Posted in the Orthopaedic Surgery Forum

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Rolf

United States

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#723
Mar 28, 2008
 
Kevin-
At 10 months post op, my repaired arm is still smaller than my "good" arm. The biceps do look different, but most don't notice. It is rounded, but it is more compact now. It is still not filling in between the bicep and elbow, and I don't think it will, because I have to guess that it is actually tighter than it was prior to the injury, so the tendon falls away quicker. Think about it...the tendon lost it's point of insertion, so a new point of insertion had to be formed using the same tendon, and it had to be stretched slightly to make that contact...it is probably only a problem for people that lift in front of mirrors that aren't concerned with checking their form...HAHAHA
Anthony

Monterey Park, CA

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#724
Mar 28, 2008
 
Six, I had the two incision method and experienced some hardening of the tissue at the point of attachment. I am now 6 1/2 weeks post op and it is almost gone. My therapist told me that this was calyst and would go away through time. I was wondering if you had any more information on calcification at the attachment and if another surgery is needed to remove it.
Anthony

Monterey Park, CA

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#725
Mar 28, 2008
 
I know that Jim had to have some calcified bone removed but did the growth occur before or after the brek jim.
Six - Miami

Miami, FL

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#726
Mar 28, 2008
 
Anthony:
Google Distal Bicep Tendon Surgery and a lot of sites come up. Also, on this blog some of the previous bloggers have had calcification. I have not really researched it because it doesn't seem to happen to people who have the single incision endo button procedure. Good luck
Zipp

Boston, MA

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#727
Mar 28, 2008
 
Rolf wrote:
Kevin-
At 10 months post op, my repaired arm is still smaller than my "good" arm. The biceps do look different, but most don't notice. It is rounded, but it is more compact now. It is still not filling in between the bicep and elbow, and I don't think it will, because I have to guess that it is actually tighter than it was prior to the injury, so the tendon falls away quicker. Think about it...the tendon lost it's point of insertion, so a new point of insertion had to be formed using the same tendon, and it had to be stretched slightly to make that contact...it is probably only a problem for people that lift in front of mirrors that aren't concerned with checking their form...HAHAHA
I know that it has atrophied and may never look the same but I have a 1" gap (bicep to elbow) and that seems like a lot for 3 1/2months after surgery. Some only have a 2" gap before surgery!
Anthony

Monterey Park, CA

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#728
Mar 28, 2008
 
Six, I realy have not seen anything on calcification around the attached area. Its probably because I have not been paying attention to this disorder and I will continue to do more research. The only thing that I have found and have been paying close attention to is heterotopic ossification, which is bone growth between the radius and ulna. As a result pronation is lost due to the inability to roll the radius to the side of the ulna.
I never thought that so many risks were involved with this procedure, If its not one thing its another. And my doctor did not help very much either. My doctor originaly told me that I was going to receive the single incision method. But the day of my surgery when I was already preped with the ivy in me, he told me that he changed his mind and decided to go with the two incision method. He also explained that there is a risk of a bone growth between the radius and ulna and that I may lose pronation. I knew I needed the porocedure and fast so I went for it. But the doctor never informed me of the possibilty of nerve damage (WHICH I HAVE). Hope my nerve heals quick, its prety tough typing one handed.
Six - Miami

Miami, FL

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#729
Mar 28, 2008
 
Anthony, I may have misspoken, my surgeon did state heterotopic ossification is a possible complication (not calcification). Sorry about the error.
Your Doctor should have told before hand about the change in procedure so that you could make an informed decision. Hope you feel better. Believe me from the time I was diagnosed 12/29/07 until my operation 1/14/08 I did a lot of research on the web inclusive of the blog. Everything that I have read seems to show that the single incision endobutton procedure is the way to go. Just my thoughts.
Anthony

Monterey Park, CA

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#730
Mar 28, 2008
 
Six, thanks for the help. I did some research before surgery but only on the single incision method. Being that the doctor decided to go with the two incision method I thought that he was the profesional and knew what he was doing. I guess I put to much trust in him. Im just glad that I did not get the bone growth, the doctor said I would have noticed it by now. But it is stupid of me to trust him again, I will be asking for an exray on my next visit.
When it comes to pronation I have no difficulty. I able to have my palm face up with little or no strain when I have my arm at the side. It is when I have my arm at full extension that pronation is limited. I was wondering if anyone else is experiencing this?
Kevin

King Of Prussia, PA

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#731
Mar 28, 2008
 
No, not really. It moves a little bit more each day. I was the opposite of your situation Anthony. I was told he was doing the 2 anchor method on me and he decided to do the endobutton after he opened my arm up. I had no clue what an endobutton was but after some research I am really glad he did that over the anchors. He told me it was twice as strong mechanically than the anchors (not sure if thats true-since I have not researched it) and that it healed quicker. I dont think he would lie since I asked a lot of questions (after I did research) that I already knew the answer to and he was always right on the money. I think a lot of these little pains and quircks will go away after we REALLY start using the arm again. Most if it I'm sure is just from the arm not being used. The human body is NOT designed to just sit around and be motionless, its built to constantly move our entire lives.
Kevin

King Of Prussia, PA

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#732
Mar 28, 2008
 
Guess he was right

"Results: The EndoButton-based technique showed a significantly higher failure load (259 28 N) than did all other techniques (P < .05). No significant differences were seen between the transosseous suture technique (210 29 N) and most other techniques (P > .05). Failure loads of the TwinFix-QuickT (57 29 N) and Biocuff screw (105 28 N) were significantly lower than those of all other repairs (P < .05). "
David G

AOL

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#733
Mar 28, 2008
 
HAS ANYONE HAD A BICEPS TENDON REPAIR REVISION SURGERY? I had a complete tear of the distal tendon and had it fixed three days later. Now they are telling me that the tendon has shredded. Does anyone have a similar experience? What did you do? Other than the shredding the operation went pretty good. Thanks.
Zipp

Duxbury, MA

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#734
Mar 29, 2008
 
Zipp wrote:
<quoted text>
I know that it has atrophied and may never look the same but I have a 1" gap (bicep to elbow) and that seems like a lot for 3 1/2months after surgery. Some only have a 2" gap before surgery!
I guess my question is: How big of a gap are others experiencing? Is my gap a sign of poor tensioning by the doctor or is it a sign of a partial tear during recovery?
Kevin

Norristown, PA

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#735
Mar 29, 2008
 
David G wrote:
HAS ANYONE HAD A BICEPS TENDON REPAIR REVISION SURGERY? I had a complete tear of the distal tendon and had it fixed three days later. Now they are telling me that the tendon has shredded. Does anyone have a similar experience? What did you do? Other than the shredding the operation went pretty good. Thanks.
I have never heard of this before. How did it "shred"?
Kevin

Norristown, PA

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#736
Mar 29, 2008
 
Zipp wrote:
<quoted text>
I guess my question is: How big of a gap are others experiencing? Is my gap a sign of poor tensioning by the doctor or is it a sign of a partial tear during recovery?
I do not notice any gap. I also really cant "flex" the bicep right now so its possible there might be one. I will have a better idea in a few weeks.
Anthony

Rosemead, CA

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#737
Mar 29, 2008
 
Woke up this morning and noticed something diferrent in my hand. There was not any pain that I usally feel every morning from soreness. Then I began to try to move my fingers and noticed my index finger is raised a lot higher then my other fingers. I feel so much beter now that I am starting to show recovery from posterior interosseous nerve palsy (6 1/2 weeks post op). I can't wait to show my therapist my progress. I also cant wait to fully recover and get rid of my prefabricated rubberband hand.
David, sorry to hear about your injury. I have not heard about anybody shreding their tendon after recovery but wish you luck and a speedy recovery.
Zipp, when you speak of a gap between what sections are you measuring from?
Rolf

Mount Vernon, OH

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#738
Mar 29, 2008
 
If you are speaking of the gap between your bicep and the inside bend of your elbow, I have a 1 finger gap on my good arm and a 2 finger gap on my repaired arm...but that isn't a problem, I don't think...it is just a result of a slightly shorter, tighter tendon. If that is not what you are refering to, then I don't understand.
Zipp

Duxbury, MA

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#739
Mar 29, 2008
 
Anthony wrote:
Woke up this morning and noticed something diferrent in my hand. There was not any pain that I usally feel every morning from soreness. Then I began to try to move my fingers and noticed my index finger is raised a lot higher then my other fingers. I feel so much beter now that I am starting to show recovery from posterior interosseous nerve palsy (6 1/2 weeks post op). I can't wait to show my therapist my progress. I also cant wait to fully recover and get rid of my prefabricated rubberband hand.
David, sorry to hear about your injury. I have not heard about anybody shreding their tendon after recovery but wish you luck and a speedy recovery.
Zipp, when you speak of a gap between what sections are you measuring from?
The "gap" I'm referrong to is from the crease of your elbow to the begining of the bicep when your arm is extended or staight. Several prior posts have referred to this gap. On a normal arm the bicep extends to the crease (more or less noticable depending on how developed the muscle is but that's where the muscle begins). In earlier posts, some have mentioned that this "gap" was only 2" when their Dr. said they needed surgery. Post surgery my gap is 1+ inches and that seems not quite right. Not sure if I've re-injured the bicep?
Zipp

Duxbury, MA

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#740
Mar 29, 2008
 
Rolf wrote:
If you are speaking of the gap between your bicep and the inside bend of your elbow, I have a 1 finger gap on my good arm and a 2 finger gap on my repaired arm...but that isn't a problem, I don't think...it is just a result of a slightly shorter, tighter tendon. If that is not what you are refering to, then I don't understand.
Sorry for the earlier rambling post. Yes Rolf, that is what I am referring to.
Zipp

Duxbury, MA

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#741
Mar 29, 2008
 
Rolf wrote:
...but that isn't a problem, I don't think...it is just a result of a slightly shorter, tighter tendon. If that is not what you are refering to, then I don't understand.
The thing is, if the tendon is shorter and it is re-attached at the same place then the muscle must be stretched longer to cover the same arm length and thus there should be no or even less of a gap.
Rolf

Mount Vernon, OH

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#742
Mar 29, 2008
 
I'm thinking (and don't know for sure, someone ought to speak to an ortho) that since it is tighter, the way the tendon goes down under your arm and throgh the inside of your elbow, it is slightly pulled down more, and would cause somewhat of a gap. Maybe not...just my impression. I might be looking at it wrong...I would say if you can flex your bicep, you are still attached.

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