Repair of distal biceps ruptures.

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?”