23 studies (randomized controlled trials, prospective cohort studies, and retrospective case series) were included in this literature review comparing surgical approaches and fixation methods in operative management of distal biceps tendon ruptures. The results indicated that the overall complication rate among all studies was 24.7%, with no significant difference whether a single or two incision approach was used. The conference abstract reported lowest complication rate in fixation using bone tunnels. Complication rates across fixation methods were 21.9% for bone tunnels, 25.8% for suture anchors, 44.8% for intraosseous screws, and 0% (0/17) for endobutton. The grounds for exclusion of endobutton data in this comparison is unknown.