Triceps tendon rupture

 

Triceps avulsion 1MRI triceps avulsion 1

 

Epidemiology

 

Rare

< 1% of all tendon injuries

 

Tom et al Clin J Sports Med 2014

- systematic review

- most common between ages 30 - 50

- 2x common in males

 

Anatomy

 

Footprint

- dome shaped insertion over olecranon

 

Mechanism

 

Eccentric contraction - weight lifting, athletes

 

Direct blow

 

Medical morbidity

- diabetes

- chronic renal failure

- rheumatoid arthritis

- corticosteroids

- anabolic steroids

 

Examination

 

Tender to insertion triceps tendon

Weakness of elbow extension

Palpable tendon gap

 

Xray

 

Olecranon avulsion

 

Triceps avulsion 1Triceps avulsion 2Triceps avulsion 3

 

MRI

 

MRI triceps avulsion 1MRI triceps avulsion 2

 

MRI triceps avulsion 3MRI triceps avulsion 4

 

Operative management

 

Repair Options

 

Transosseous sutures

 

Suture anchors

 

Anatomic repair

- suture bridge / double row

- two proximal suture anchors

- distal knotless anchors / tranosseous fixation

- restore triceps footprint

 

Triceps tear 1Triceps repair 2Triceps repair 3

Anatomic triceps repair with proximal suture anchors and double row transosseous repair

 

Surgical technique PDF anatomic repair

 

Results

 

Balazs et al Injury 2016

- 48 acute triceps rupture repaired acutely in military populations

- 6/48 (13%) traumatic rerupture rate at 4 months post surgery

 

Mirzayan et al Am J Sports Med 2018

- 184 triceps repair < 90 days post injury

- mean age 49

- higher failure rate for transosseous repairs (7%) versus anatomic repairs (0%)

 

Dunn et al Hand (N.Y.) 2017

- Systematic review

- 89% returned to preinjury level of function

- 6% re-rupture rate

 

Triceps tendon reconstruction

 

Vumedi triceps tendon reconstruction