Case report shows surgical exploration resolves posterior interosseus nerve palsy after biceps repair, indicating careful surgical technique is critical.
Case: A 34-year-old man developed weakness in finger extension following distal biceps repair, suggestive of posterior interosseus nerve (PIN) palsy. Surgical nerve exploration demonstrated direct PIN entrapment beneath the cortical button. Removal of the button resolved the patient's postoperative palsy. Conclusion: Precise placement of the cortical button is of utmost importance during repair of the distal biceps. Specifically, seating centered on the face of the bicipital tuberosity in line with the long axis of the radius will reduce the risk of PIN compression. If a PIN palsy should occur, surgical exploration and possible removal of the Endobutton should be considered.
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McDonald et al. (2026) studied this question.
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