Distal biceps rupture: follow the tendon to the tuberosity

Question 1Why can a distal biceps tendon look intact in the elbow crease after a complete tear?

1. aAn intact lacertus fibrosus can hold the torn tendon close to its normal position
2. bThe tendon always tears at the musculotendinous junction
3. cThe tendon reattaches within hours
4. dAnisotropy hides retraction

Question 2Where must you follow the distal biceps tendon to exclude a complete tear?

1. aTo the coracoid process
2. bTo its insertion on the radial tuberosity
3. cTo the olecranon
4. dTo the lateral epicondyle

Question 3The distal tendon looks dark near the bone in long axis. What do you do first?

1. aDiagnose a partial tear
2. bPress the lower end of the probe to bring the beam to 90° to the fibres
3. cIncrease the depth
4. dSwitch to colour Doppler

Question 4Which forearm movement helps you see the insertion?

1. aAbducting the shoulder
2. bFlexing the wrist against resistance
3. cRotating from supination to pronation while you watch the tuberosity
4. dExtending the fingers

Question 5Why does a distal biceps rupture need early referral?

1. aIt needs urgent vascular repair
2. bSurgical repair gives the best results before the tendon retracts and scars
3. cIt heals fully with a sling alone
4. dIt always causes compartment syndrome