Chronic Injuries to the Distal Biceps and Triceps Tendons: Current Evidence, Treatment Strategies, and Clinical Implications.

BACKGROUND

Chronic ruptures to the distal biceps and triceps tendons of the elbow are rare but clinically relevant injuries that may result in persistent functional impairment if left untreated. Tendon retraction, scarring, and degeneration significantly complicate surgical management and require meticulous diagnostic and therapeutic planning.

OBJECTIVE

This review summarises current evidence on the epidemiology, diagnosis, and treatment strategies for chronic ruptures to the tendon of the distal biceps and triceps tendon and aims to provide clinically applicable recommendations.

CONTENT: Conservative treatment of chronic distal biceps ruptures frequently results in persistent strength deficits, particularly in supination. Surgical reconstruction-either primary or using autograft or allograft augmentation-generally yields favourable functional outcomes, although it is associated with the risk of specific complications. For chronic triceps ruptures, partial tears may achieve satisfactory results with conservative management, whereas complete or > 50% defects typically require surgical reconstruction. Graft-based reconstructions are often necessary and can restore good function, although re-rupture rates remain relevant.

CONCLUSION

Surgical treatment is particularly beneficial for young, active, and physically demanding patients, while conservative approaches may be reasonable in low-demand individuals. Careful indication, detailed imaging assessment, and individualised decision-making are essential. Further high-quality prospective studies are required to refine surgical techniques, graft selection, and postoperative rehabilitation protocols.