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Am J Orthop 1997 Jul;26(7):489-90
University of Southern California, Women's and Children's Hospital, Los Angeles, USA.
Avulsion of the triceps tendon is an uncommon injury typically occurring in skeletally mature individuals. Although the diagnosis can be suggested by the physical findings and initial radiographs, it may be missed, especially when severe swelling of the soft tissues prevents an accurate physical examination and the radiographs do not show a small fragment of bone accompanying the avulsed tendon. This report describes an avulsion of the triceps tendon in an adolescent boy. Magnetic resonance imaging was useful in confirming the diagnosis
Int Orthop 1994 Oct;18(5):273-5
Department of Orthopaedic Surgery, University Hospital, Leiden, The Netherlands.
A 36 year old woman with a history of chronic renal failure secondary to acute glomerulonephritis sustained an injury to the tendon of the triceps brachii in her right arm. Magnetic resonance imaging showed an incomplete rupture of the tendon. The injury was successfully treated conservatively.
Can J Surg 1992 Apr;35(2):203-7
Division of Orthopedic Surgery, St. Michael's Hospital, University of Toronto, Ont.
A 25-year-old man who had a complete intramuscular rupture of the long head of the triceps was treated nonoperatively and followed up prospectively for 10 years. The injury occurred after 4 days of white-water kayaking without any direct blow. Strengthening was performed by doing push-ups. Nine years of isokinetic testing revealed that isometric strength was normal, but endurance testing was reduced by 5% to 10%. Ruptures of the muscle belly can occur due to direct trauma or by forced elbow flexion during triceps contraction. From this and the few case reports available it appears that nonoperative treatment is effective and recommended for patients who do not require significant endurance strength in elbow extension. Whether or not the results can be improved by surgical repair is uncertain.
Orthop Rev 1990 Jun;19(6):533-6
University of Texas Medical Branch, Galveston.
Avulsion of the triceps tendon is a rare injury. The clinical examination, including a test for complete rupture of the tendon, radiographic findings, characteristics of the normal maturation of the olecranon, and the surgical treatment of this injury are reviewed.
Sportverletz Sportschaden 1988 Sep;2(3):120-1
Aus der Sportklinik Stuttgart-Bad Cannstatt, Klinik fur Orthopadische Chirurgie und Sportmedizin.
Subcutaneous rupture of the triceps tendon is mostly preceded by previous damage. Local injections, systemic anabolics, metabolic disorders, damage due to overstrain in heavy athletes and body builders are risk factors. Surgical treatment is mandatory. If the rupture has occurred mainly at the point of insertion of the tendon, we can recommend transosseous refixation via V-bore channels with early functional follow-up treatment.
Clin Orthop 1984 Apr;(184):183-5
Rupture of the triceps tendon is rare, and no previous report of its association with olecranon bursitis was found in the literature. A previously healthy 72-year-old man fell from a stationary bicycle and was examined by his family physician. Calcification over the olecranon area with an intact triceps tendon was revealed. Two months later the patient presented with triceps rupture and weakness of elbow extension with olecranon bursitis. Grossly, the pathologic lesion consisted of synovial frond proliferation and invasion of the cut end of a tendon. A "collar stud-shaped" bursa was found in front of and behind the triceps tendon and across a 3-cm gap in the tendon. The advancement was completed by splitting the tendon in partial thickness proximal to the cut end. The flap was turned down and anchored to the olecranon through drill holes. The end result was good return of function. Patients with chronic olecranon bursa problems should be carefully examined for triceps function. The gap in the tendon can be treated by mobilizing the tendon in the manner described.
Clin Orthop 1981 Nov-Dec;(161):242-6
Avulsion of the triceps tendon should be suspected in patients who have pain about the elbow following a deceleration stress to the upper extremity. In three cases, the avulsion occurred both with or without a concomitant blow to the posterior aspect of the arm. Examination revealed pain, swelling, and a palpable depression just proximal to the olecranon. Roentgenograms showed avulsed osseous material. In the evaluation and management of triceps avulsion, it was important to differentiate between complete and partial tears. Careful examination of active range of motion of the elbow was the most important factor in making this determination. An avulsion was considered partial only if normal elbow motion and extension against resistance were found on follow-up examination a few days postinjury. Nonoperative management was successful in one case of partial tear (Case 2). Surgical therapy was advisable for complete avulsions. Surgical repair was successful using heavy nonabsorbable suture through olecranon drill holes. Injuries of tendon avulsion and rupture are likely to become more common as the number of patients with chronic renal failure, on dialysis, increases. Tendo-osseous weakness and related musculoskeletal disorders in renal osteodystrophy patients are unsolved problems.
J Trauma 1978 Sep;18(9):677-9
The rarity of triceps tendon avulsion is called into question by our series of 6 cases collected over a 5-year period in a small, isolated Israeli community. The even rarer occurrence of triceps avulsion accompanying fractures of the radial head is more obviously contradicted by the 3 or 4 instances of such combined injuries in our series. Awareness that a fall on the outstretched arm, with or without fracture of the radial head, is sufficient cause of the triceps avulsion or tear ought to increase the frequency of the diagnosis. Just as fractures of the proximal ulna oblige the clinician to look for dislocations of the radial head (Monteggia or Hume fractures) (6), so must falls on the outstretched arm bring to mind the possibility of triceps tendon tears. Seemingly trivial findings then become significant, and the clinical entity thus crystallizes into the diagnostic syndrome.
J Trauma 1975 Sep;15(9):827-9
Two cases of the rare injury of avulsion of the triceps tendon are presented. The difficulties in clinical diagnosis and proper evaluation of the roentgenographic findings whenever present are discussed and the treatment is outlined.
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