Introduction and Objectives: In distal avulsion of the biceps, the treatment of choice is re-attachment of the tendon. The aim of this study is to compare both surgical techniques.

Materials and Methods: Between September 2004 and February 2007, 22 consecutive patients with distal biceps rupture were randomly assigned to one of the 2 treatment groups. In group A, 11 patients underwent tendon reattachment with an Endobutton^® through a single anterior incision and in group B, 11 patients underwent tendon reattachment by means of a procedure using 2 bioabsorbable Panaloc^® harpoons placed through a double anterior and posterior approach. Mean age and interval between rupture and surgery were similar in both groups.

Results: Mean operation time was 44 minutes in group A and 65 minutes in group B. There were no complications in group A. Two patients in group B suffered transient neurapraxia of the posterior interosseous nerve and 2 presented heterotopic ossification. At 12 months there were no significant differences in the Mayo Elbow Performance Score, mobility, time of return to work or strength.

Discussion and Conclusions: Although both groups had similar functional results, anterior repair using an Endobutton must be considered the technique of choice for distal biceps avulsions because of the shorter operation time and less morbidity.