Graft Repair Method -

In few cases, the diagnosis is made after 3-4 weeks passed since the rupture has occurred. Such cases forces the surgeon to make larger incision in the front of the elbow. There is a chance that the tendon might have retracted further, up the arm. So re-connecting the biceps to its original attachment position demand graft tissue. A curved incision is made across the arm. The incision is made just above the joint of the elbow. The incision curves along the front surface of the upper arm. This reveals the lower part of the biceps muscle. Then the radial tuberosity surface is removed. A small cavity is created within the tuberosity using a burr. At the rim of the tuberosity, several suture holes are drilled. A curved instrument is made to pass through the incision. This instrument is then allowed to pass directly between the radio-ulna bones. As it passes through this space, it is forced to pass puncturing through the muscles and soft tissues. The protrusion of the muscle is felt at the back of the forearm. Another incision is made at that spot of protrusion.

Then a graft of tissue is prepared to lengthen the retracted biceps tendon. Some surgeons prefer using a piece of hamstring tendon for the graft. While others use a section of the Achilles tendon. This section of the Achilles Tendon is attached to the heel. Such a graft is an allograft. Because the tissue that is used is taken from the store of human tissue preserved for medical use. During use also, the surgeon leaves a small piece of the heel bone attached to the tendon piece. Small holes are drilled into this bone piece through which the sutures are woven.

The lower end of the graft is made to pass between the space of the radio-ulna. And then exiting through the second incision made on the back of the forearm. The sutures are then threaded into the holes from the bony end of the graft. The sutures are then tied and the graft is secured.

The surgery end with the closing of the incisions and placing the elbow in a protective brace.