A 47-year-old, self-employed contractor lifts a large board and feels a “pop” on the anterior aspect of his elbow. He continues to work but experiences anterior elbow pain and realizes he is weak when he tries to tighten a screw with a screwdriver. The next morning the arm is swollen and ecchymotic. He cannot fully extend the elbow and has pain trying to turn the palm up. He is evaluated 8 days later and has regained full elbow motion. The biceps tendon cannot be palpated in the antecubital fossa with the elbow flexed and the forearm supinated. He has no noticeable difference in elbow flexion strength but has reduced supination strength. Radiographs and a magnetic resonance imaging scan were obtained before presentation. The radiographs are normal. The magnetic resonance imaging scan shows a complete rupture of the distal biceps. The patient's contracting business is the sole support for his family. He wants to know what will happen if he “leaves this alone,” and “If I get it fixed, will I be as good as new?”

Polls results

On a scale of 1 to 10, rate how much this article will change your clinical practice?

NO change
BIG change
85% Article relates to my practice (6/7)
14% Article does not relate to my practice (1/7)
0% Undecided (0/7)

Will this article lead to more cost-effective healthcare?

42% Yes (3/7)
42% No (3/7)
14% Undecided (1/7)

Was this article biased? (commercial or personal)

14% Yes (1/7)
85% No (6/7)
0% Undecided (0/7)

What level of evidence do you think this article is?

28% Level 1 (2/7)
28% Level 2 (2/7)
0% Level 3 (0/7)
14% Level 4 (1/7)
28% Level 5 (2/7)