Distal Biceps Repair



A Distal Biceps Rupture is when a tear forms in the tendon connecting the bicep muscle to the radius bone. The result is pain, and a pronounced difficulty flexing and rotating the arm from a palms-down, to a palm-up position. This movement is known as supination.

Your Arm Biceps are: The large muscles in the upper arm that enable you to bend your elbow and rotate your forearm.

  • Injury and overuse are the most common causes of a bicep rupture.
  • Men between the age of 40 and 60 are at the highest risk.
  • Often a “pop” sound is heard from the elbow at the time of injury.
  • Once the bicep tendon is torn, it does not grow back and reattach to the bone.

Patients with a distal biceps rupture often report:

  • An unexpected, eccentric extension force applied to the flexed elbow
  • Bruising
  • A bulge in the upper arm
  • A “pop” sound at the elbow
  • A noticeable weakness when flexing the impacted arm
  • Pain when arm is at a 90 degree angle with the palm facing upward


Dr. Alkhatib and his team of health professionals will greet you and start your visit with a discussion of your symptoms, sport, level of competition, desired activity level and mechanism of injury. Next, the doctor will exam your biceps, focusing on:

  • Evidence of bruising (ecchymosis)
  • Evidence of tenderness, especially surrounding the biceps muscle and tendon
  • Whether or not the distal biceps tendon can be felt or not
  • Whether or not proximal muscle retraction is seen in the upper arm
  • Weakness when arm is flexed

Dr. Alkhatib may request an MRI to confirm the rupture or any degeneration.



A nonsurgical approach is usually considered for:

  • Elderly patients
  • Sedentary patients
  • Patients who wish to avoid surgery
  • Patients who are too ill to undergo surgery


Anatomic repair is recommended for patients with a confirmed distal biceps tendon rupture—especially when a patient’s partial tears fail to respond to nonsurgical treatment. Dr. Alkhatib’s technique is considered the strongest technique and allows for the most rapid healing and return to activity.

During surgery, Dr. Alkhatib will:

  • Remove unhealthy parts of the tendon
  • Reattach the tendon to the bone (radial tuberosity) using a metal button