Heterotopic ossification with adhesion to the distal biceps tendon and brachial artery displacement following distal biceps repair: a case report

Ruptures of the distal biceps brachii tendon are injuries that most frequently affect the dominant arm of middle-aged men. Surgical repair is indicated in active patients to restore elbow flexion and forearm supination strength. Complications of repair include neurovascular injury, elbow stiffness, re-rupture, wound infection, and heterotopic ossification. Heterotopic ossification is a rare complication that may be asymptomatic or present with pain, restricted range of motion, palpable mass, or neurovascular symptoms. We report a case of heterotopic ossification with adhesion to the distal biceps tendon and displacement of the brachial artery following open repair using a single-incision approach. The patient presented 7 months postoperatively with restricted range of motion. Surgical excision of the ossification and tenolysis for tendon release were performed, preceded by preoperative radiation therapy. Postoperative follow-up demonstrated full range of motion and complete resolution of symptoms.