The Elbow

Distal Biceps Avulsion

Occurence

A distal avulsion of the biceps is an uncommon injury.
It typically occurs in men between the fourth and the sixth decades of life.
Avulsion typically occurs during a heavy lift with the elbow flexed approximatively 90° and is the result of a sudden prolonged contracture of the biceps against high load resistance.

Clinical Evaluation

The patient experiences a popping or tearing sensation and presents with acute swelling and pain in the antecubital fossa.
There is mild to moderate ecchymosis in the antecubital fossa and the distal biceps is not palpable.
Active flexion and supination of the elbow are still possible (brachialis and supinator remain intact) - but the resisted flexion and supination movements are weak.

Treatment

Surgical reinsertion of the biceps into the radial tuberosity