Prognosis for recovery of posterior interosseous nerve palsy after distal biceps repair

BackgroundThere is very little information on the incidence of and usual recovery period for posterior interosseous nerve (PIN) palsies after distal biceps repair. This study examined the incidence and the time to resolution of PIN palsies in a large consecutive series of primary distal biceps repairs.Materials and methodsA retrospective review was performed of a consecutive series of patients treated by 34 fellowship-trained upper extremity surgeons with primary distal biceps repair through a single anterior incision technique. Patients' records were reviewed to determine how many experienced a postoperative PIN palsy, defined as postoperative digital extension weakness on clinical examination. Demographic information, surgical fixation used, and clinical resolution was collect for these patients. All patients had clinical follow-up until complete resolution of PIN palsy symptoms.ResultsWe found 280 patients who were treated with a single-incision technique and 1 of 2 methods of biceps tendon fixation. Of these, 9 (3.2%) developed a postoperative PIN palsy after primary distal biceps repair. These 9 patients had complete lack of finger and thumb extension at the first postoperative visit and had complete resolution of symptoms at an average of 86 days (range, 41-145 days).ConclusionsThe incidence of PIN palsy after a single-incision distal biceps repair was 3.2% in our series. These injuries typically resolve within 3 months, and at the latest, 5 months after surgery.