A 66 year-old man presents with right anterior elbow pain, ecchymosis, and a “lump” in his right upper extremity after a ground level fall (Figure 1). What is your suspected diagnosis? What physical exam maneuver(s) can help you confirm your diagnosis? What is your initial workup in the ED? What imaging confirms the diagnosis? What is your management and disposition?
Check out ALiEM’s Paucis Verbis cards to brush up on other can’t miss orthopedic injuries, and SplintER Series for more elbow cases.
References
- Srinivasan RC, Pederson WC, Morrey BF. Distal Biceps Tendon Repair and Reconstruction. J Hand Surg Am. 2020 Jan;45(1):48-56. doi: 10.1016/j.jhsa.2019.09.014. PMID: 31901332.
- Tarallo, L., Lombardi, M., Zambianchi, F. et al. Distal biceps tendon rupture: advantages and drawbacks of the anatomical reinsertion with a modified double incision approach. BMC Musculoskelet Disord 19, 364 (2018). PMID: 30305070.
- García Rodríguez C, García-Polín López C, Del Olmo Hernández T, Moros Marco S, Jacobo Edo O, Ávila Lafuente JL. Distal biceps tendon rupture: diagnostic strength of ultrasonography and magnetic resonance. Rev Esp Cir Ortop Traumatol (Engl Ed). 2020 Mar-Apr;64(2):77-82. English, Spanish. doi: 10.1016/j.recot.2019.11.004. Epub 2020 Jan 27. PMID: 32001186.
- Logan CA, Shahien A, Haber D, Foster Z, Farrington A, Provencher MT. REHABILITATION FOLLOWING DISTAL BICEPS REPAIR. Int J Sports Phys Ther. 2019 Apr;14(2):308-317. PMID: 30997282; PMCID: PMC6449020.
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