H.F.

2 Posts
 
Posted - 04/14/2006 :  15:03:23  Show Profile  Reply with Quote
Does anyone have any insight or protocols for treating a distal bicep tendon repair? I will be seeing a patient that has undergone this surgery and have not seen anyone with this dx before.
Thanks
Hank

SCPT

USA
10 Posts
 
Posted - 04/15/2006 :  18:16:19  Show Profile  Reply with Quote
Distal Bicep Tendon Repair (Froedert Hospital- Dr. Grindel/Daly)

Immediately Postoperative:-Post operative dressing/splint applied, positioned in elbow flexion with wrist neutral- supination. Allow functional shoulder and hand ROM

7-10 days post:
-First follow up with MD
-Stitches removed if well healed
-Placed in Bledsoe elbow hinge brace or long arm splint positioned at 75-90 flexion (resting position)- wrist included
-Adding 10 deg extension to resting position per week
-Scar management
-Full gentle Passive flexion allowed
-Gentle Passive supination/pronation as tolerated
-Gravity assisted active extension to resting position (75-90 flexion), adding 10 degrees per week
-Precaution: slow progression into extension
-Continue treatment 1 x weekly to monitor and upgrade

Week 4-6:
-Begin gentle A/AAROM and P/PROM as toelrated into elbow flexion, and supination/pronation
-Gentle P/PROM into extension
-Expect residual limited elbow extension to be approximately 15-30 degrees
-D/C splint for protection, may use Bledsoe to assist with gaining end motion at night

Week 8-10:
-Full A/PROM as tolerated
-Begin gentle strengthening, progress slowly

Note:
-Discuss with MD the tension of the repair, and whether allograft was used
-Maximum lifting and physical labor is slowly progressed, not until 6 months post operatively are limitations lifted