07-16-2015, 04:35 PM
(07-14-2015, 03:12 AM)fredtoast Wrote: But you will never have much strength and will probably not even be able to use a screwdriver if it is on your dominate arm.
If you have a ruptured bicep tendon treated nonsurgically you're strength during elbow flexion and supination will be reduced, but you will have plenty of strength to use a screw driver. Unless you're a competitive athlete or do strenuous physical labor that requires maximum supination strength, the orthopedist may not recommend surgery. Like I wrote before, surgery is based upon many factors and it should be individualized and it is not a given.
http://emedicine.medscape.com/article/327119-treatment#showall
Quote:Surgical Intervention
Treatment of biceps tendon ruptures is a topic of debate. Several reviews of surgical repair versus conservative (nonoperative) management report conflicting results; neither a complete agreement nor a general clinical consensus has been reached. Although no concrete evidence provides unconditional support for one treatment protocol, the results of these reviews ultimately may lend credence to the long-standing practice of individualizing treatment to each patient's circumstances.
Generally accepted clinical guidelines advocate surgical repair consisting of tenodesis and subacromial decompression proximally (or anatomic reattachment distally) for young or athletic patients or for persons who require maximum supination strength.[url=http:://bengalsboard.net/javascript:showrefcontent('refrenceslayer');][4, 20] [/url]Cosmetic concerns may prompt a surgical approach when appearance is unacceptable to the patient following rupture.[url=http:://bengalsboard.net/javascript:showrefcontent('refrenceslayer');][21, 22, 23, 24][/url]
Conservative management is considered appropriate for middle-aged or older patients and for those who do not require a high degree of supination strength in daily activities. This approach involves rest, followed closely by ROM and strengthening exercises for the shoulder and elbow. Conservative therapy provides an effective and highly tolerable means of treatment; in most practice settings, the number of patients who are managed conservatively is greater than the number who undergo surgical repair. Various follow-up studies have reported that in nonoperative management, patients lose up to 20% of their supination strength, although the overall level of impairment rarely impacts activities of daily living (ADL).
Currently, it seems prudent to employ individualized and comprehensive treatment strategies tailored to each patient's needs. Such strategies consist of the following:
- A thorough evaluation for coexisting shoulder and elbow pathology
- Risk/benefit discussions concerning surgical repair, according to each patient's needs, desires, age of injury, and other relevant information that has been ascertained (Surgical referrals are made most often for patients requiring maximum biceps function or for individuals who are suffering intolerable pain that limits function.)
- A focus on appropriate rehabilitation efforts aimed at maximizing functional capacity, regardless of acute management
