{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T23:25:20Z","timestamp":1789082720351,"version":"build-2803163510"},"reference-count":48,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Shoulder &amp; Elbow"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Single-incision and double-incision techniques are widely used for distal biceps tendon repair, yet debate continues over which yields better outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search was conducted across PubMed, Scopus, Cochrane Library, and Google Scholar through May 2025. Nineteen studies involving 2833 adult patients met inclusion criteria. Assessed endpoints included visual analog scale for pain, disabilities of the arm, shoulder and hand (DASH) scores, elbow ROM assessments, isometric flexion strength, heterotopic ossification, radioulnar synostosis, nerve injuries including lateral antebrachial cutaneous nerve (LACN), posterior interosseous nerve (PIN), and superficial radial nerve (SRN). Additionally, rerupture rates and other complication rates were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with the double-incision approach, the single-incision technique was associated with improved DASH scores (MD: \u22121.08,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.01), greater elbow flexion (MD: 8.18\u00b0,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.001), higher isometric flexion strength (MD: 6%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.02), and greater pronation (MD: 4.29\u00b0,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.03). It was also associated with a lower incidence of heterotopic ossification (risk ratio (RR): 0.51,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.02) and radioulnar synostosis (RR: 0.07,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Conversely, the double-incision technique was associated with lower rates of LACN and SRN injuries (RR: 4.45,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.001; and RR: 2.74,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.005, respectively) but remained susceptible to PIN injury (RR: 0.48,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.02). Infection, rerupture, reoperation, stiffness, delayed wound healing, and persistent pain rates were comparable between techniques (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The single-incision technique appears to be associated with more favorable objective functional outcomes and fewer structural complications, whereas the double-incision approach may reduce the risk of certain sensory nerve injuries. Further high-quality randomized trials are required to confirm these associations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17585732251399838","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T17:04:12Z","timestamp":1766423052000},"page":"814-834","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparing single-incision and double-incision techniques in distal biceps tendon repair: A systematic review and meta-analysis"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9902-7878","authenticated-orcid":false,"given":"Guy","family":"Awad","sequence":"first","affiliation":[{"name":"Universit\u00e9 Saint-Joseph de Beyrouth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1765-4222","authenticated-orcid":false,"given":"Marc","family":"Boutros","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Saint-Joseph de Beyrouth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Hajj Youssef","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Saint-Joseph de Beyrouth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassem","family":"Elhassan","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"e_1_3_2_2_2","first-page":"193","article-title":"Distal biceps tendon ruptures: a historical perspective and current concepts","volume":"30","author":"Bernstein AD","year":"2001","unstructured":"Bernstein AD, Breslow MJ, Jazrawi LM. 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