Late repair of simultaneous bilateral distal biceps brachii tendon avulsion with fascia lata graft

A 50 year old rock climber sustained a bilateral rupture of the distal bice ps brachii tendons. He retained some flexion power in both arms but minimal supination, being weaker on the non-dominant right side. As the patient pr esented late, with retraction and shortening of the biceps muscle bellies, reconstruction was carried out using fascia lata grafts on both sides. Beca use of residual weakness on the left (dominant) side, three further surgica l procedures had to be carried out to correct for elongation of the graft. A functionally satisfactory outcome, comparable with that on the right side , was eventually obtained. In summary, bilateral fascia lata grafts to brid ge the gap between the retracted biceps bellies and the radial tuberosities were successful in restoring function and flexion power to the elbow Despi te being the stronger side, the dominant arm did not respondas well to the initial surgery This may be due to overuse of this arm after the operation.