12:15 – 1:30 PM
General LMA Anesthesia with Post-Operative Long-Acting Regional Block

This patient sustained an injury to his elbow region when moving his Christmas tree from the roof on his car.  He lost control of the tree and tried to grab it as it fell.  The result was rupture of the biceps tendon attachment at the elbow (radial tuberosity).  Here you can see the typical retraction and deformity of the muscle as well as the bruising over the inside of the forearm close to the elbow.

The MRI axial cut of this patient reveals the biceps tendon ruptured and with fluid filling its sheath (arrow). 

A two-inch single incision over the anterior forearm, beginning at the elbow flexion crease and proceeding to the hand was utilized for repair.  Through this incision, the biceps insertion site, the radial tuberosity, was exposed.

Once the tuberosity was exposed, a small surgical instrument is used to remove the remnant fibers of the tendon and the site is prepared for biceps tendon re-insertion.

The tendon was then prepared and sutured using four suture strands emanating from two suture anchors which were placed in the radial tuberosity.  These sutures were then used to secure the tendon to the bone.  This repair was exceedingly secure such that therapy and motion was initiated 6 days later.  After one year, this patient hand full painless motion and was stronger on the operated compared with the uninjured arm.