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What is Distal Biceps Repair?

The biceps is a large muscle located in the front of your upper arm and runs from the shoulder to the elbow joint. It is attached to the bones of the shoulder and elbow by tendons. The distal biceps is the area where the biceps is attached to the forearm bone in the elbow. The tendon may be partially or completely ruptured by heavy lifting or by forible extension of the elbow.

Distal biceps repair is a surgical procedure to restore a completely ruptured or torn distal biceps tendon.

Symptoms of distal biceps tendon rupture

  • “Pop” or tear felt in the front of the elbow
  • Severe pain around the crease of the elbow
  • Bruising and swelling around the front of the elbow
  • Weakness in bending of the elbow or supinating the forearm (turning the hand to a palm up position)
  • “Popeye sign” where the biceps muscle retracts, becoming shorter and more prominent


Your surgeon will explain the procedure, its complications and benefits, and answer any questions you may have.

  • To avoid certain medicines such as blood thinners before the surgery
  • To arrange for a friend or family member drive you home after the surgery
  • To fast after midnight prior to your surgery

How is the Distal Biceps Repaired?

The distal biceps is usually repaired through a single incision (front of the elbow) or a double incision (front and back of the elbow) technique, depending on individual circumstances.

During the procedure:

  • You will be administered a regional (block) anesthesia to numb the arm.
  • A small incision is made at the elbow, and the torn or ruptured end of the biceps located.
  • Any damaged tissues are removed using specialized instruments.
  • Small holes are then drilled into your forearm bone (radius bone).
  • Strong threads (sutures) are woven into the distal biceps tendon.
  • The sutures are attached to a metal anchor or button
  • The button is passed through the drill hole(s) in the radius bone, securing the tendon to the bone
  • The incision is closed with stitches and a dressing is applied.
  • Your elbow is protected with the use of a brace and a sling.
  • The sutures are removed after a week and gentle physical therapy may begin shortly after.
  • No lifting of more than a few pounds is allowed in the surgically repaired arm until at least a month postoperatively

More chronic injuries may need a tendon graft (transplanted tissue taken from a deceased donor) to repair the distal biceps in cases of insufficient tendon material.

  • NASS
  • AAOS
  • American Association of Hip and Knee Surgeons (AAHKS)
  • Tufts University School of Medicine
  • Newton-Wellesley Hospital