The Distal Triceps Tendon Footprint and a Biomechanical Analysis of 3 Repair Techniques

Abstract

Anatomic repair better restores preinjury anatomy compared with other types of repairs and demonstrates less repair-site motion, which may play a role in early postoperative management.

Distal Triceps Knotless Anatomic Footprint Repair Is Superior to Transosseous Cruciate Repair: A Biomechanical Comparison

“…Because this study is an addition to the already published article by Yeh et al, 11 a simple paired Student t test was used to compare the 2 repair techniques regarding cyclic displacement, load at yield, peak yield, and stiffness.…”

“…After debridement of any grossly pathologic tendon tissue, one No. 2 highstrength nonabsorbable suture was used to suture the triceps tendon in locking Krakow fashion with 5 passes up and down starting and ending at the distal triceps tendon tip medially and laterally, as previously described by Yeh et al 11 The triceps footprint was identified, and crossed 2-mm tunnels were drilled from the proximal footprint to the dorsal ulnar surface, taking care to avoid entering the ulnohumeral joint. A suture passer was then used to pass the medial and lateral strands through the crossed tunnels.…”

“…Failure of the construct was considered when there was greater than 10 mm of displacement of the tendon from the bone tunnel. 11 Footprint restoration assessment was made for each repair with the MicroScribe G2 3D Digitizer (Immersion, San Jose, CA) and Rhinoceros modeling software (Kelvin Educational, Farmingdale, NY).…”

Ruptures and avulsions of the distal tendon of the triceps brachii

“…An additional fourth head of the triceps muscle has sporadically been reported arising from the posteromedial aspect of the proximal humerus [14,15]. The distal confluence of the muscular heads constitutes the distal tendon proper of the triceps brachii, which inserts 12 mm distal to the tip of the olecranon process of the ulna over an area of 466 mm 2 [16].…”

Distal Triceps Knotless Anatomic Footprint Repair: A New Technique

“…Most recently, Yeh et al 12 compared the anatomic and biomechanical properties of the standard transosseous cruciate suture technique with both a single-row 2esuture anchor repair and their "anatomic" transosseous-equivalent repair method featuring 4 suture anchors in a double-row configuration. They showed better footprint coverage and decreased gap formation with their anatomic repair, as well as a trend toward increased load to yield that did not reach statistical significance.…”