Single-incision distal biceps tendon repair using spinal retractors to achieve optimum exposure

Achieving and maintaining adequate, safe exposure during single-incision distal biceps repair can be a challenge, particularly in well-muscled individuals. To maintain visualisation of the radial tuberosity, it is necessary to fully supinate the forearm and to place deep right-angled retractors rather than levered retractors to protect the posterior interosseous nerve.1,2 It can be difficult for the assistant to simultaneously maintain retraction and forearm supination and to operate accessory instruments, especially if the elbow must be flexed to reduce the tendon to the tuberosity. Consequent loss of visualisation may compromise safety and efficiency