Orthopedic Center with Orthopedist and Arthroplasty Services

BREAK OR AVULSION OF THE TRICEPS TENDON

Rupture of the triceps tendon

Tearing and rupturing of the triceps tendon is extremely rare and the least common among all tendon injuries. In a study that evaluated 1,104 cases of tendon ruptures, less than 15% were cases related to the triceps tendon.

 

To understand more about the rupture of the triceps tendon, please continue to read the characteristics, causes, and surgical treatment.

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Several factors can alter the structural integrity of the triceps tendon and affect its capacity to carry weight or bear strain. Ruptures can happen spontaneously to patients with healthy tissue or diseases that predispose them.

Main injury mechanism

One of the primary ways the triceps tendon may get injured is by falls that affect the extended hand. Additionally, lifting weights and lack of posterior elbow strength are also common causes of injury.

In addition to direct trauma, overloading the tendon through the uncoordinated contraction of the triceps against the flexed elbow may lead to tricep tendon ruptures too.

 

Breaks

Rupture tears may be complete or incomplete and may involve different anatomical regions. Some tears occur close to the origin of the lateral head of the triceps, while others occur through the muscular belly of the triceps, the muscle tendon junction, or the tendon itself.

Reports of injuries at the tendon or intramuscular muscle junction are rare. The rupture of the triceps tendon occurs at the point of insertion into the olecranon; while most ruptures also include bone avulsion in the olecranon. Medical professionals still debate regarding the best treatment for partial tears of the triceps tendon. When breaks occur, you may need rehabilitation and improvement of the tear may be achieved through conservative treatment or surgery.

 

Complete break

Unlike partial triceps tendon breaks, complete ruptures always require surgical treatments. This is also an option for patients who have high functional demands and need to regain their mobility entirely.

For more information about the characteristics of the triceps lesions and their treatments, please continue reading ahead.

Cases of triceps tendon break repair surgery

Patient

A male patient arrived at the hospital’s emergency arthroplasties with pain and functional impairment in his left elbow after experiencing a fall while playing football (he was in the goalkeeper position).

Exam

The clinical examination revealed diffuse swelling, stiffness, and ecchymosis in the region around the left elbow. A well-defined space was visible above the olecranon and there was a lack of active elbow extension.

X-ray

A lateral radiograph of the elbow displayed a fragment posterior to the olecranon fossa. Considering the presence of the bone fragment on the lateral x-ray, the palpable space, bruise on the posterior elbow, and a complete deficit in elbow extension, diagnosing a complete rupture of the triceps tendon was fairly simple.

Since the diagnosis was visible, Magnetic Resonance Imaging (MRI) was not seen as a necessary diagnostic tool in this case.

After the trauma

Six hours after the trauma was sustained, the surgery was performed. With the patient under regional anesthesia, a tourniquet was applied, and a direct posterior incision was made.

The radiograph of the elbow showed the fragment near the tip of the olecranon in the lateral view.

Break

A complete rupturing of the distal insertion of the triceps tendon was found. The tendon was soft, and degenerated at its end with some bone fragments embedded in it.

Debridement

The rupture was repaired after debridement of the distal aspect of the tendon, the cortex of the olecranon, and the removal of bone flakes. Two anchors were placed in the olecranon and a transosseous suture was used in the tendon with a permanent braid.

Immobilized Elbow

In order to aid the healing process, the elbow was immobilized in a 45 degree flexion. Isometric exercises were allowed until the third postoperative day, and were followed by three weeks of progressive active flexion with a cuff to control mobility.

4 months later

After 4 months of active and passive movement exercises, the patient achieved complete elbow movement. They left the cuffs that were restricting mobility and the contraction of the triceps began. After six months, the patient was able to enjoy complete and painless movements of the joint and achieved complete muscle recovery.

Understanding the tear of the triceps tendon

We hope you were able to understand the causes, risk factors, and possible prognosis of triceps tendon ruptures. If you’re experiencing any symptoms or have sustained an injury, please schedule an appointment with us immediately.

Our experienced doctors will provide accurate diagnoses, effective treatments, and rehabilitation strategies to help you regain your functionality.

Source: MANCINI F, BERNARDI G, DE LUNA V, TUDISCO C. Surgical repair of isolated triceps tendon rupture using a suture anchor technique: a case report.
Available at: www.ncbi.nlm.nih.gov/pmc/articles/PMC5297350/

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Unidade Higienópolis
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