Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of sharp, tearing pain in the antecubital fossa following a sudden eccentric load to the flexed elbow. Reports a subjective "pop" sensation, followed by immediate weakness in forearm supination and elbow flexion. No prior history of similar symptoms.
Clinical Examination Findings
Physical exam reveals ecchymosis and localized edema in the antecubital fossa. Palpation demonstrates a palpable defect in the distal biceps tendon insertion. Hook test is positive, indicating loss of tendon integrity. Significant weakness noted in resisted forearm supination and elbow flexion compared to the contralateral side. Neurovascular status intact distally.
Treatment Protocol
Plan: Immobilization in a posterior splint with the elbow at 90 degrees of flexion and neutral forearm rotation. Referral to orthopedic surgery for evaluation of surgical repair versus conservative management. Analgesics initiated for pain control. Ice application and elevation advised.