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Rupture of the distal tendon of the biceps muscle is a rare injury. If unrepaired the patient will be left with weakness of supination of the arm and flexion in the elbow. Long term results for the 2-incision approach for tendon reinsertion are few but in this study we describe the long term, clinical, functional, and subjective results of surgical repair using the 2-incision method described by Boyd and Anderson. ⋯ Despite heterotopic ossification and a small ROM deficit the Boyd and Anderson technique for repair of distal biceps ruptures yields good long term results in a low volume rural hospital. Early diagnosis and tendon reinsertion is of great importance to avoid persistent anterior elbow pain and poor subjective results.