RESULTS OF OPERATIVELY VERSUS NONOPERATIVELY MANAGED DISTAL BICEPS RUPTURE

Distal Biceps Tendon Rupture (DBTR) can be managed operatively or non-operatively depending on patient preference. This study aimed to evaluate the outcomes of both treatment options within a single health board. All DBTR between July 2020–2025 received a structured questionnaire. Patients were given the option of surgery through a single-incision approach with subsequent 8-week bracing protocol, or non-operative treatment with unrestricted activity. From 90 DBTR total, 25 chose conservative management and 65 chose surgery. Response rate was 30% (21 surgical, 6 conservative). Mean age was 46 with and 51 without surgery. Median return to physical work was 8-weeks with and 0-weeks without surgery. Median return to sports was 20 weeks with and 15 weeks without surgery. Median QuickDASH score was significantly higher (indicating higher disability) in the non-operative group (26.5 vs 12, p= 0.01) with a difference exceeding the minimal clinically important difference. Perceived arm normality was significantly higher in the operative group versus the conservative group (8 vs 2, p= 0.01). Perceived elbow flexion strength was also significantly higher in the operative group compared to the conservative group (8 vs 5, p = 0.02). 20 (95%) surgical participants would choose the same treatment again but only 1 (17%) in the conservative group would. This data demonstrates superior patient-perceived functional outcomes and satisfaction with operative treatment of DBTR compared to conservative management. However, conservative treatment may allow quicker return to physical work and sports and may still be preferable in some patients.