The rupture of the distal tendon of the biceps brachii muscle is a relatively rare injury in humans, with only 4 to 10% of all tendon ruptures of the biceps brachii affecting the distal tendon. The genesis of this injury is discussed in relation to specific anatomical structures, degeneration of various pathomechanisms, and peak loads. Initially, conservative therapy was accompanied by a significant strength deficit of up to 40% regarding supination and 30% regarding flexion, but it has increasingly been replaced by surgical procedures, which come with individual advantages and disadvantages concerning complications such as nerve injuries, heterotopic ossifications, and infections. Furthermore, significant differences are discussed between the functional outcomes of various surgical procedures and compared to conservative treatment. This work evaluates two surgical techniques for the re-fixation of the distal biceps tendon in terms of specific advantages and disadvantages of these techniques, as well as significant differences in individual functional outcomes.