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The standard 4- to 5-cm transverse incision centered over the radial tuberosity provides excellent exposure for the repair. If there is concern about excessive tendon retraction, a “lazy S”-shaped incision across the elbow crease can be used to enhance proximal exposure.
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Take care to identify and preserve key neurovascular structures.
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Fully supinate the forearm to visualize the entire radial tuberosity and identify the center of the footprint.
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Ensure that the tendon reaches the tuberosity with the elbow in 30° of flexion before final repair.
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Once the button is deployed, sequentially tension sutures to the desired level of tension.