Hook Test for Biceps Tendon Rupture: Easy Diagnosis & Treatment Explained скачать в хорошем качестве

Hook Test for Biceps Tendon Rupture: Easy Diagnosis & Treatment Explained

The Hook Test is a quick and easy way to diagnose a distal biceps tendon rupture. Learn how to perform this simple orthopedic exam, understand the treatment options, and see real clinical examples. If you’re experiencing elbow pain or weakness, this test helps detect a torn biceps tendon. Early diagnosis is key to better recovery! Channel and Subscription Links: Your YouTube Channel:    / nabilebraheim   Subscribe Link: https://www.youtube.com/user/nabilebr... Subscribe for regular updates on orthopedic procedures: https://www.youtube.com/user/nabilebr... #BicepsRupture #HookTest The hook test. The hook test is a test used to diagnose distal biceps tendon rupture, avulsion or a tear. The biceps tendon inserts at the radial tuberosity. When the biceps tendon ruptures, it causes pain at the elbow. The patient will experience a sharp, sudden painful pop at the elbow from unexpected extension force when the elbow at 90 degree of flexion. The condition occurs in middle-aged men, usually involve the dominant extremity. It is a single traumatic event with eccentric force on the flexed elbow. There might be ecchymosis at the elbow and weakness of supination and flexion of the elbow. There might be a palpable defect with proximal retraction of the biceps muscle belly called reverse Popeye sign. If rupture of the tendon is not diagnosed and repaired, then there will be loss of 40% to 50% of supination and 30% of flexion of the elbow. The hook test is performed to diagnose rupture or tear of the distal biceps tendon. The examiner will use the index finger to hook the tendon from the lateral side of the elbow. How do you do the hook test? The patient flexes the elbow to 90 degree and fully supinate the forearm. Use the index finger to hook the lateral edge of the biceps tendon. If the tendon is intact or partially torn, the finger can be inserted below the tendon and hook it. If you cannot hook the tendon, then there is a complete tear of the tendon. There might be false positives involved with the hook test such as with partial tear of the distal biceps or with intact lacertus fibrosis or mistakenly hooking the brachialis tendon. Another test to diagnose the distal biceps tendon tear is called the squeeze test which is similar to the Thompson test for the Achilles tendon rupture. The way you do it, you flex the elbow to 80 degree and keep the forearm in some pronation and squeeze the biceps by one hand or by two hands. Supination of the forearm will occur if the biceps is intact. No supination will occur if the biceps is torn. The problem with diagnosing distal biceps tendon tear is to differentiate between partial tear and complete tear because both have the same clinical pictures. You could see a palpable defect in a complete tear that will help. The partial tears are rare and frequently misdiagnosed and under-diagnosed. The patient will have pain in the elbow but the patient also will have a normal hook test so this is the time to get the MRI. The MRI here may be helpful. MRI may not be needed in all cases. MRI will diagnose the tear, the degree of retraction and if the tear is complete or partial. Treatment The treatment for a distal biceps tendon rupture depends on the severity of the injury and the patient’s functional demands. Non-surgical management may be considered for low-demand patients or those who decline surgery, involving physical therapy to strengthen compensatory muscles and improve functional ability. However, non-surgical treatment results in significant loss of supination and flexion strength. Surgical repair is the preferred option for active patients, typically performed within two to three weeks of injury to prevent excessive tendon retraction. The procedure involves reattaching the biceps tendon to the radial tuberosity using either a single-incision or a dual-incision technique with suture anchors, cortical buttons, or interference screws. Delayed repair may require graft augmentation if the tendon has significantly retracted. Postoperatively, patients undergo immobilization followed by a progressive rehabilitation program focusing on restoring range of motion, strength, and function. Quiz Questions 1. What is the primary function of the Hook Test? ✅ A. Diagnose distal biceps tendon rupture B. Assess medial epicondylitis C. Detect radial nerve palsy D. Evaluate triceps tendon integrity Explanation: The Hook Test is specifically used to diagnose a rupture of the distal biceps tendon. 2. What is a common false positive finding in the Hook Test? ✅ A. Hooking the brachialis tendon instead of the biceps B. Lack of pain with elbow flexion C. Radial head subluxation D. Loss of elbow extension Explanation: Mistakenly hooking the brachialis tendon or an intact lacertus fibrosis can lead to a false positive Hook Test.