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Intrinsic hand weakness
1%
56/5952
Numbness of the volar radial three and a half digits
2%
131/5952
Wrist extension weakness
15%
883/5952
Numbness to lateral aspect of volar forearm
73%
4329/5952
Inability to flex thumb and index interphalangeal joints
9%
513/5952
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The lateral antebrachial cutaneous nerve is the nerve most commonly injured during the repair of distal biceps rupture using a two-incision technique. Paresthesia of this nerve is the most common complication of distal biceps repair and is usually the consequence of aggressive retraction. It is most at risk during surgical dissection between the biceps and brachialis muscles. This purely sensory nerve supplies feeling to the lateral aspect of the forearm, as depicted in Illustration A. Kelly et al retrospectively looked at the complications of repair of the distal biceps tendon with the modified two-incision technique in 74 patients. Among the nerve injury complications, five sensory nerve paresthesias (three lateral antebrachial cutaneous and two superficial radial nerve paresthesias) occured. They also had one patient develop a temporary palsy of the posterior interosseous nerve which resolved in six months. Bisson et al also studied the complications of this technique. In 45 patients, they had 14 complications. Half of these were due to nerve dysfunction, with the lateral antebrachial nerve being the most common nerve injured. Illustration V is a surgical techniques video demonstrating a single incision technique with use of an endobutton.
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