2001 OITE Question 167

Question

Following reinsertion of the distal biceps tendon, early rehabilitation should include:

1- Active elbow flexion and active forearm supination

2- Active elbow flexion and passive forearm supination

3- Active elbow extension and active forearm supination

4- Passive elbow extension and active forearm supination

5- Passive elbow flexion and passive forearm supination

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Answer (click for answer)

Preferred response: 5

Early rehab includes only passive motion to protect the tendon repair. For the first three weeks post op, the elbow is maintained in 90 degrees of flexion using a static splint. A hinged orthoplast splint is then applied with a dynamic flexion component that provides for passive flexion. Active extension is allowed and encouraged. The use of this splint is continued for 4 to 6 weeks. About 10 weeks after surgery, if flexion strength has returned to near-normal as determined clinically or by biomechanical functional strength assessment, the splint is discarded, and gradual resumption of normal activity is encouraged. Full activity is not recommended for 6 months after the surgical repair.

Reference: Morrey BF: Tendon injuries about the elbow, in Morrey BF (ed): The Elbow and its Disorders, ed 2. Philadelphia, PA, WB Saunders, 1993, pp 492-504.