Background This study aims to compare clinical and functional results after distal biceps tendon repair in manual workers vs. non-manual workers. Methods This is a retrospective comparative study which refers to 57 cases with distal biceps tendon rupture, divided in manual workers (24 elbows) and non-manual workers (33), that were treated by a single incision with cortical button and interference screw fixation. Included cases have a minimum of 3 months follow-up, post-operative X-ray and signed informed consent for the investigation. Results Supination and flexion strength was higher in manual workers vs. non-manual workers (p-value = 0.192 and 0.878, respectively). Nine patients showed loss of range of motion, concerning supination and pronation, and this was correlated to worse functional scores. Functional scores tend to be superior in non-manual workers. Ten patients had heterotopic ossification and 20 patients reported lateral antebrachial cutaneous nerve neuropraxia
one had both. Most of them had a full recovery. Conclusion According to clinical evaluation and post-operative scores, the performed surgical procedure provides good to excellent mid-term functional results. Nevertheless, there were not any differences between manual or non-manual workers.