Repairs Of The Biceps And Triceps Tendons

What you should know

Repair of the biceps (BI-seps) and triceps (TRI-seps) tendons (TEN-dons) is surgery to repair a ruptured (torn) biceps or triceps tendon. Tendons connect muscles to bones, and together with muscles, work to move your arms, legs, fingers, and toes. The biceps and triceps tendons are tendons in the arms. They connect the biceps and triceps muscles to the scapula (shoulder blades) and elbows. A complete or partial rupture of these tendons usually happens after trauma or an injury. The complete tendon rupture may be acute or chronic based on the duration of time from injury. Injuries occurring within four weeks are considered as acute, and after four weeks they are chronic. Distal tendon ruptures (tendon ruptures near the elbow) are injuries that usually need surgery. Sharp pain, tenderness, and swelling over the front or back of the elbow are common signs and symptoms.

During the surgery, the ruptured biceps or triceps tendon is sewn back to the bone. Your caregiver may use special tools, such as buttons and screws, to attach the tendon to the bone. He may also put some holes in the bones to insert the ends of the ruptured tendon. Tendons taken from other parts of the body may also be used to replace damaged tendons. This is usually done for chronic tendon injuries. After surgery you may need a splint or cast to protect the tendon and help it heal. You may need to do special exercises to help build the strength back in your arm. With repair of the biceps and triceps tendons, your regular arm movements may be returned, and normal activities restored.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

There are always risks with surgery, such as bleeding and infection. Other parts of the arm, such as nerves, blood vessels, ligaments, muscles, and bones may be damaged. Your arm, forearm, hand, or fingers may become stiff, numb, and weak. Even after a successful surgery, your arm movement may not be the same as it was before. You may have trouble going back to your usual activities, including sports. If left untreated, the pain and problems you have with your arm may get worse. Call your caregiver if you are worried or have questions about your surgery, medicine, or care.

Getting Ready

The week before your surgery:

• Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.
  
  
• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• You may need to have blood tests, an electrocardiogram (ECG), chest x-ray, and other tests. Ask your caregiver for more information about these tests. Write down the date, time, and location of each test.

The night before your surgery:

• Remove any nail polish.
  
  
• You may be given medicine to help you sleep.
  
  
• Ask caregivers about directions for eating and drinking.

The day of your surgery:

• What to bring: You may want to bring items such as a toothbrush and bathrobe.
  
  
• Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• Bring with you any papers your caregiver has given you to sign.
  
  
• If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.
  
  
• Do not wear tight-fitting clothes on the day of your procedure or surgery.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your surgery. Tell your caregiver if you or any member of your family has had a problem using anesthesia in the past.
  
  
• You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the surgery. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.

Treatment

What will happen:

• You will be asked to change into a hospital gown. You may be given medicine in your IV to help you relax or make you drowsy. You will be taken on a stretcher to the operating room. You will be given a general or regional anesthesia that will numb the area with the ruptured tendon. Your shoulder, arm, forearm, and elbow will be cleaned with soap and water and then covered with sheets.
  
  
• In a repair of biceps tendons, an incision (cut) will be made over the front of the elbow. Another incision may be made on the back of the elbow to help your caregiver with the surgery. He will then sew the tendon back to the bone. He may attach buttons and screws to the bone where the tendon may be fastened. In triceps tendons repair, an incision will be made on the back of the elbow. Holes will be drilled in the end of the ulna (one of the bones in the forearm). The ends of the tendon will be inserted through the holes and tied with stitches (threads).
  
  
• A tendon or fascia (hard tissue) from another part of the body may be used for chronic tendon injuries. This is done to make the shortened tendon longer so it reaches the bone where it will be attached. The incisions will then be closed using stitches or surgical tapes and covered with bandages. A cast or splint will be placed on the elbow. This will protect the tendon and keep it from moving while it heals.

After your surgery:

You may lie in bed and rest for a while since the surgery may be tiring. When your caregiver sees that you are OK, you will be allowed to change clothes and go home. You will need someone to drive you home. Do not drive home alone. If your caregiver wants you to stay in the hospital, you will be taken back to your hospital room.

Contact a caregiver if

• You cannot make it to your appointment on time.
  
  
• You have a fever.
  
  
• You have a skin infection or an infected wound near the injured tendon.
  
  
• You have questions or concerns about your surgery.

Seek Care Immediately if

• The problems for which you are having the repair of the tendon get worse.
  
  
• You have a lot more pain or have trouble moving your arm, forearm, hand, or fingers.