Case Report: Snapping Biceps Femoris Tendon Due to Abnormal Fibular Morphology

BACKGROUND: Several cases of snapping biceps femoris tendons have been reported with anomalous insertions of the distal tendon insertion or in the context of trauma. There are only three published cases due to abnormal fibular head morphology.

METHODS/RESULTS: We present a case of unilateral snapping of the biceps femoris tendon in a 19 year old. We decided to proceed with surgery after the patient failed a trial of non-operative treatment and had significant functional limitations. Surgical exploration of the posterolateral knee showed a prominent ridge on the posterior aspect of the fibular head over which the biceps femoris tendon was snapping with deep knee flexion. The bony ridge was resected, leaving surrounding structures intact, including the insertion of the biceps femoris tendon. The patient experienced resolution of snapping symptoms and associated pain.

CONCLUSIONS: Although rare, snapping of the biceps femoris tendon can cause pain and functional limitation. In this case, resection of a prominent ridge on the fibular head resolved snapping and pain. Level of evidence: Level five.