A fit and healthy 54 year old surf lifesaver presented to the Emergency Department with an injury to his right upper limb. Whilst trying to hold on to a wayward boat by its rope, he felt a ripping sensation and severe pain over his distal biceps tendon. The clinical picture of complete rupture of distal biceps tendon was confirmed by Ultrasound Scan. Case Report A fit and healthy 54 year old surf lifesaver presented to the Emergency Department with an injury to his right upper limb. Whilst trying to hold on to a wayward boat by its rope, he felt a ripping sensation and severe pain over his distal biceps tendon. The clinical picture of complete rupture of distal biceps tendon was confirmed by Ultrasound Scan.The patient underwent surgery for repair of his distal biceps tendon 9 days later. The distal tendon was reattached using suture anchors through a single incision approach.13 Patient was immobilized in a splint for 6 weeks following the surgery. Range of motion exercises were started at the 6 week mark and patient made initial improvements. At 8 weeks patient complained of increasing pain at the distal radius with elbow flexion and forearm pronation/supination. On examination, a firm mass was palpable over the distal biceps tendon. Flexion range was limited from 25-105? with only 20? of supination and 35? of pronation. X-Ray Radiograph revealed heterotopic ossification (HO) of the distal biceps tendon (see figure 1). The extent of the HO was further defined by Computed Tomography (CT) Scan (see figure 2).
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