The Orthobullets Podcast

Foundations | Shoulder & Elbow | Distal Biceps Avulsion

Sep 13, 2025
Explore the intriguing world of distal biceps avulsion, from its surprising prevalence to its revealing symptoms. The discussion covers various treatment options while highlighting potential surgical complications. Clinical scenarios are presented to deepen understanding, making complex concepts accessible for frontline MSK providers. Perfect for those looking to bolster their foundational knowledge in orthopaedics!
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INSIGHT

Mechanism And Imaging For Diagnosis

  • Distal biceps avulsions occur at the radial tuberosity from excessive eccentric loading.
  • MRI helps distinguish complete versus partial tears and retraction degree.
INSIGHT

Anatomic Details Matter

  • The biceps has two distinct distal insertions with different footprints on the radial tuberosity.
  • The lacertus fibrosis can mimic an intact tendon on exam and protects neurovascular structures.
ADVICE

How To Perform The Hook Test

  • Use the hook test with the elbow at 90 degrees and full supination to assess tendon integrity.
  • Be aware false positives occur with partial tears, intact lacertus fibrosis, or underlying brachialis tendon.
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