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Bilateral Distal Biceps Tendon Ruptures.

Journal of Hand Surgery - American, 2011

METHODS: A retrospective review of 321 patients who underwent operative repair of a distal biceps tendon rupture between 1988 and 2010 identified 26 patients with bilateral ruptures.
We recorded patient age, mechanism of injury, time between symptom onset before the first surgery and subsequent contralateral symptoms, and time between surgeries.
RESULTS: Twenty-two bilateral ruptures were confirmed intra-operatively, 2 by MRI, and 1 was lost to follow up.
Excluding the 2 women (age 72 and 79 years), the average age at the initial rupture was 42 years and the average age at subsequent rupture was 46 years.
The initial rupture occurred in the dominant extremity in 50% of cases and in the nondominant extremity in 42% of cases; a total of 8% were not documented.
Thirty-three percent were heavy laborers, 3 patients had a smoking history, and 1 patient reported a history of steroid use.
88% of patients had the second side repaired, where we noted that 55% of the second tendon ruptures were partial tears.
CONCLUSIONS: The 8% cumulative incidence of bilateral biceps tendon ruptures in a consecutive series of biceps tendon repairs may be higher because not all patients were contacted, which introduced a sampling bias.
This 8% rate is markedly higher than the reported rate of 1.2 per 100,000 for an isolated distal biceps tendon rupture.
This implies that patients with a distal biceps tendon rupture are at risk for a rupture on the contralateral side.