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I had surgery to repair a biceps tendon rupture (down by the elbow). I ended up with nerve damage AND bone growing in the surgical area. My mind keeps going over and over whether or not this would have happened with a different (younger? older?) surgeon. Maybe a younger guy (or gal) would have had more up-to-date ideas. Maybe an older surgeon with more experience would have known better what to do. Emotionally, I'm a mess. What do you suggest?
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Studies show that chronic injuries (repaired more than 30 days later) have the highest rate of postoperative complications. It's easier for the surgeon to find the end of the torn tendon, pull it back to the bone where it belongs, and reattach it if the procedure is done before scar tissue and contracture (stiffness) occurs at the tendon/muscle interface.
A recent study of this matter conducted in Florida might provide you with some helpful information for your situation. Surgeons from four large orthopedic centers combined their research efforts to create a large patient data base. A total of 178 medical files of patients were reviewed. Each patient had a distal biceps tendon surgical repair. Only those patients who had a fracture, elbow dislocation, or traumatic laceration (cut) to the biceps were excluded from the study.
Information collected from the patient charts included age, sex (male or female), time between injury and surgery, surgical technique used, and post-operative complications. Anyone who had surgery 30 or more days after the injury was considered to have a chronic injury. Those patients who had surgical repair in the first 29 days after injury were labeled acute.
The problems that developed after surgery were divided into two categories: minor and major. Analysis of the information collected showed that slightly more than one-third (36 per cent) of all patients experienced some problems after surgery. Most of these were minor and temporary. Numbness from nerve injury and skin infections were the most common minor complications.
Major complications occurred much less often (eight per cent of the total) and included more serious nerve injury, painful heterotropic ossification, and rerupture. Heterotropic ossification refers to the formation of bone tissue in the tendon and muscle causing stiffness, loss of motion, and pain. Most of the reruptures were caused by trauma because of patients who did not follow the surgeon's instructions.
Although there were five different surgeons who did the surgeries, there were no significant differences in results from one to another. The number of complications was the same no matter what surgical approach or technique was used. Patients with chronic injuries had slightly higher rates of postoperative problems.
We don't know your circumstances (e.g., whether the injury was acute or chronic, extent of the injury, your level of compliance after surgery) but these could be factors in your results. Based on the study we mentioned, there's no evidence that the surgeon's level of experience or expertise contributed in a negative way to the results of surgery.
Surgeons do everything they can to prevent problems or complications from developing after surgery of any kind. In the case of distal biceps tendon ruptures, if it looks like the procedure is too risky due to the possibility of damage to nearby blood vessels and nerves, then the surgeon might advise the patient to avoid surgery and treat the problem conservatively.
Since you have already had the surgery, the best approach is to follow your surgeon's advice carefully. With time and sometimes additional surgery and/or a rehab program supervised by a hand therapist, patients do regain function. Many cases of nerve damage are temporary with full recovery possible.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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