Background:
Few large-scale series have described functional outcomes after distal
triceps tendon repair. Predictors for operative success and a comparative
analysis of surgical techniques are limited in the reported literature.
Purpose:
To evaluate short-term to midterm functional outcomes after distal triceps
tendon repair in a broad patient population and to comparatively evaluate
patient-reported outcomes in patients with and without pre-existing
olecranon enthesopathy while also assessing for modifiable risk factors
associated with adverse patient outcomes and/or revision surgery.
Study Design:
Case series; Level of evidence, 4.
Methods:
This study was a retrospective analysis of 69 consecutive patients who
underwent surgical repair of distal triceps tendon injuries at a single
institution. Demographic information, time from injury to surgery, mechanism
of injury, extent of the tear, pre-existing enthesopathy, perioperative
complications, and validated patient-reported outcome scores were included
in the analysis. Patients with a minimum of 1-year follow-up were
included.
Results:
The most common mechanisms of injury were direct elbow trauma (44.9%),
extension/lifting exercises (20.3%), overuse (17.4%), and hyperflexion or
hyperextension (17.4%). Eighteen patients were identified with pre-existing
symptomatic enthesopathy, and 51 tears were caused by an acute injury. A
total of 36 complete and 33 partial tendon tears were identified. Bone
tunnels were most commonly used (n = 30; 43.5%), while direct sutures (n =
23; 33.3%) and suture anchors (n = 13; 18.8%) were also used. Perioperative
complications occurred in 21.7% of patients, but no patients experienced a
rerupture at the time of final follow-up. No statistically significant
relationship was found between patient age (
P
= .750),
degree of the tear (
P
= .613), or surgical technique
employed (
P
= .608) and the presence of perioperative
complications.
Conclusion:
Despite the heightened risk of perioperative complications after primary
repair of distal triceps tendon injuries, the current series found favorable
functional outcomes and no cases of reruptures at short-term to midterm
follow-up. Furthermore, age, surgical technique, extent of the tear, and
mechanism of injury were not associated with adverse patient outcomes in
this investigation. Pre-existing triceps enthesopathy was shown to be
associated with increased complication rates.