Elbow tendon injury
Distal biceps rupture
A partial or complete tear of the biceps tendon where it attaches near the elbow.
The distal biceps tendon helps bend the elbow and, especially, turn the palm upward. It can tear during a sudden force when the elbow is being straightened, often while catching or lowering a heavy object. Complete tears in active patients are usually evaluated promptly because delayed repair can become more difficult.
See the anatomy and imaging
What tears
The tendon usually pulls away from its attachment on the radius. A complete rupture disconnects the muscle from the forearm bone; a partial tear leaves some fibers attached. The amount of weakness and treatment options differ between these patterns.
Evaluation
The examination checks the tendon contour, bruising, strength, and a hook test. X-rays exclude bone injury. Ultrasound or MRI may help distinguish a partial from complete tear or clarify an uncertain examination.
Nonsurgical treatment
Nonsurgical care may be reasonable for selected lower-demand patients, people with substantial surgical risk, or some partial tears. Pain often improves, but a complete unrepaired tear can leave lasting loss of forearm rotation strength and endurance.
Surgical repair
Repair reattaches the tendon to the radius using sutures with a button, anchor, or other fixation. Early evaluation is useful because the tendon can retract and scar over time. Chronic tears may require a larger exposure or graft reconstruction.
Recovery
The repair is protected while the tendon heals to bone. Motion and strengthening advance in stages, and heavy lifting returns gradually over several months. Rehabilitation balances protection against elbow stiffness.
Important risks
- Temporary or persistent numbness from nearby nerve irritation
- Heterotopic bone or loss of forearm rotation
- Re-tear, stiffness, infection, or weakness
- Rare injury to the posterior interosseous nerve
Evidence and further reading
Educational content is reviewed for patient clarity and is not a substitute for an examination or individualized medical advice.
PIA Shoulder MD