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A 4cm incision is made
2cm distal to the elbow crease, overlying the biceps
tuberosity of the radius. |
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Biceps Tendon is retrieved
and a No. 5 Ticron whip-stitch
inserted. The tendon edge is debrided and chevron shaped. |
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Chevron shape of distal
biceps tendon. |
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The chevron is sized for
a Biotenodesis screw. Only the chevron portion of the
distal tendon will enter the hole with the screw, due
to the large surface area of the biceps tendon and small
area of |
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the biceps tuberosity.
Two Fiberwire (Arthrex) sutures are inserted in a modified
Kessler fashion:
1. into the chevron portion of the tendon.
2. into the broader section (for overtying). |
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The pilot hole is drilled
in the biceps tuberosity of the radius - with the forearm
fully supinated.
A 5mm drill-bit was used here.
It is essential to use the Biotenodesis drill guide to
protect the soft tissues - the radial nerve and posterior interosseous
branch are very close by. |
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The most distal Fiberwire
suture (in the chevron tip) is passed through the Biotenodesis
inserter, with a 5.5mm screw mounted. This is best done
with a wire passer (Arthrex). |
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Insertion of the screw
(1) |
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Screw insertion, as per
Biotenodesis system guidelines (2). |
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Insertion
of screw & tendon
(3) |
|
|
| |
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| Screw
and chevron portion in position.
Then Ticron whip-stitch suture tied to Fiberwire to allow
further apposition and support. |
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Wound Closure |
