Heterotopic ossification of the elbow

Richard S. Page, Gregory Leverett, Gregory Bain

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


Distal biceps rupture is an uncommon injury, usually affects males in their fourth decade or older, and accounts for just 3% of all biceps ruptures. The functional results of non-operative treatment are generally poor, and acute injuries are best treated early with surgical repair. Missed or untreated chronic injuries present a challenge to reconstruct due to retraction and loss of musculotendinous length.

Traumatic ruptures and surgical repairs are both at risk of complication by heterotopic ossification (HO). Repairs that have failed are also at risk of HO, which is a challenge to treat, more so when the biceps is retracted and requires reconstruction. The need to re-establish tendon length and combined elbow flexion-rotation power often necessitates an interposition tendon graft. This is particularly the case to restore function at higher repetitive torque loads. This chapter explores the treatment options of distal biceps ruptures in the chronic setting, technical considerations including autografting, outcomes, and an approach to managing concurrent HO.
Original languageEnglish
Title of host publicationSurgical Techniques for Trauma and Sports Related Injuries of the Elbow
EditorsGregory Bain, Denise Eygendaal, Roger P. van Riet
Place of PublicationBerlin
Number of pages6
ISBN (Electronic)9783662589311
ISBN (Print)9783662589304
Publication statusPublished - 2020


  • Elbow
  • Late reconstruction
  • Biceps rupture
  • Heterotopic ossification
  • Function


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