Distal partial ruptures of triceps brachii tendon in an athlete

Abstract

Distal brachii triceps tendon rupture is rare. Partial lesions are not so well defined. If functionally they are well tolerated in patients with low functional demand, management guideline is not so clear for sportsmen. To our best knowledge, there is no reported technique for the repair of partial forms. A 28-year-old patient was operated on for a partial triceps rupture. He underwent a transosseous olecranon suture of the tricipital tendon, with a side-to-side suture to the healthy residual tendon. The patient was assessed at 2 years follow-up with the DASH score. He had painless and mobile elbow with no effusion and returned to sport 4 months after his surgical repair. The extension strength was comparable to the healthy side (5/5). The DASH score was 1,7 for global score, and 6,3 for work and sport modules. Partial rupture of brachii triceps tendon is not well tolerated in high functional demand patients. We think that patients should be operated in these situations and may achieve excellent results. Postoperative management is crucial to achieve good results as well as in complete rupture.

Distal triceps injuries (including snapping triceps): A systematic review of the literature

“…Partial tears can be located on the superficial tendon only (combined lateral or long head)[6-8] but have also been described for the deep portion of the tendon in isolation (medial head)[5,9,10] the central one third of the tendon in isolation[10], the lateral portion in isolation[10], the lateral and central portion combined[10] or involving the medial and long head insertions with the lateral portion intact[10,11]. …”

“…Palpable defects are commonly found and present in up to 80% of patients[10,21,22,31]. Partial tears may be easily missed as patients may have a good range of active motion, but do typically present with reduced power on extension of the elbow[5,6,9,15,18,20,31]. …”

“…Generally surgery has been reported to give good improvement in the Morrey score, Mayo, ASES, Oxford elbow scores and DASH[6,9,14,21,29]. It is reported to significantly reduce pain and improve muscle strength[6,10,19].…”

Synthetic Augmented Suture Anchor Reconstruction for a Complete Traumatic Distal Triceps Tendon Rupture in a Male Professional Bodybuilder with Postoperative Biomechanical Assessment

“…Even though these injuries represent the 0.8% of all upper extremities tendon injuries in athletes [5], the risk of exhibiting a distal triceps tendon rupture in bodybuilding is particularly high [6–8]. Predisposing factors are anabolic steroid use [8–10], local steroid injection, and chronic tendinopathy [1, 11].…”

“…Many techniques exist such as the currently favored anatomical suture anchor refixation [4, 5, 15]. However, in competitive bodybuilding, only very few reports exist regarding triceps tendon rupture and operative reconstruction [2, 6–8, 16]. The outcome of primary tendon repair depends on tendon quality and injury chronicity [11, 17].…”