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Published in: European Journal of Orthopaedic Surgery & Traumatology 3/2012

01-04-2012 | Expert's Opinion

Ruptures and avulsions of the distal tendon of the triceps brachii

Authors: Ali Hassan Chamseddine, Roger M. Jawish, Abdallah A. Alasiry, Hadi K. Zein

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 3/2012

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Abstract

Ruptures and avulsions of the distal triceps tendon are reportedly rare. Various local and systemic conditions have been reported predisposing to rupture. Ruptures may be complete or partial and may occur without or with avulsion of bony fragment from the posterior aspect of the olecranon process. They may easily be missed in acute stage. MRI constitutes a reliable tool for diagnosis as well as to disclose complete and partial forms. Association of triceps ruptures with bony and ligamentous injuries to the elbow has been recently reported. A comprehensive approach treating simultaneously all associated lesions is mandatory. Early surgical repair usually gives satisfactory functional results. Chronic unrepaired complete ruptures lead to serious disability of the elbow function with weak extension strength. This article aims at reviewing the current concepts on this subject.
Literature
1.
go back to reference Partridge R (1868) A case of rupture of the triceps cubiti. Med Times Gaz 1:175–186 Partridge R (1868) A case of rupture of the triceps cubiti. Med Times Gaz 1:175–186
2.
go back to reference Anzel SH, Covey KW, Weiner AD (1959) Disruption of muscles, tendons. An analysis of 1014 cases. Surgery 45:406–414PubMed Anzel SH, Covey KW, Weiner AD (1959) Disruption of muscles, tendons. An analysis of 1014 cases. Surgery 45:406–414PubMed
4.
go back to reference Farrar EL 3rd, Lippert FG 3rd (1981) Avulsion of the triceps tendon. Clin Orthop 161:242–246PubMed Farrar EL 3rd, Lippert FG 3rd (1981) Avulsion of the triceps tendon. Clin Orthop 161:242–246PubMed
5.
go back to reference Pantazopoulos TH, Exarchou E, Stavrou Z, Hartofilakidis-Garofalidis G (1975) Avulsion of the triceps tendon. J Trauma 15:827–829PubMedCrossRef Pantazopoulos TH, Exarchou E, Stavrou Z, Hartofilakidis-Garofalidis G (1975) Avulsion of the triceps tendon. J Trauma 15:827–829PubMedCrossRef
6.
go back to reference De Waal Malefijt MC, Beeker TW (1987) Avulsion of the triceps tendon in secondary hyperparathyroidism: a case report. Acta Orthop Scand 58:434–435PubMedCrossRef De Waal Malefijt MC, Beeker TW (1987) Avulsion of the triceps tendon in secondary hyperparathyroidism: a case report. Acta Orthop Scand 58:434–435PubMedCrossRef
9.
go back to reference Van Riet RP, Morrey BF, Ho E, O’Driscoll SW (2003) Surgical treatment of distal triceps ruptures. J Bone Joint Surg Am 85:1961–1967PubMed Van Riet RP, Morrey BF, Ho E, O’Driscoll SW (2003) Surgical treatment of distal triceps ruptures. J Bone Joint Surg Am 85:1961–1967PubMed
10.
go back to reference Yeh PC, Dodds SD, Smart LR, Mazzocca AD, Sethi PM (2010) Distal Triceps rupture. J Am Acad Orthop Surg 18:31–40PubMed Yeh PC, Dodds SD, Smart LR, Mazzocca AD, Sethi PM (2010) Distal Triceps rupture. J Am Acad Orthop Surg 18:31–40PubMed
13.
go back to reference Gray H (1995) Gray’s Anatomy. The anatomical basis of medicine and surgery, 38th edn. Churchill Livingstone, New York, p 844 Gray H (1995) Gray’s Anatomy. The anatomical basis of medicine and surgery, 38th edn. Churchill Livingstone, New York, p 844
14.
go back to reference Fabrizio PA, Clemente FR (1997) Variation in the triceps brachii muscle: a fourth muscular head. Clin Anat 10:259–263PubMedCrossRef Fabrizio PA, Clemente FR (1997) Variation in the triceps brachii muscle: a fourth muscular head. Clin Anat 10:259–263PubMedCrossRef
16.
go back to reference Yeh PC, Stephens KT, Solovyova O, Obopilwe E, Smart LR, Mazzocca AD, Sethi PM (2010) The Distal Triceps tendon footprint and a biomechanical analysis of three repair techniques. Am J Sports Med 38:1025–1033. doi:10.1177/0363546509358319 PubMedCrossRef Yeh PC, Stephens KT, Solovyova O, Obopilwe E, Smart LR, Mazzocca AD, Sethi PM (2010) The Distal Triceps tendon footprint and a biomechanical analysis of three repair techniques. Am J Sports Med 38:1025–1033. doi:10.​1177/​0363546509358319​ PubMedCrossRef
17.
go back to reference Belentani C, Pastore D, Wangwinyuvirat M, Dirim B, Trudell DJ, Haghighi P, Resnick D (2009) Triceps brachii tendon: anatomic-MR imaging study in cadavers with histologic correlation. Skeletal Radiol 38:171–175. doi:10.1007/s00256-008-0605-6 PubMedCrossRef Belentani C, Pastore D, Wangwinyuvirat M, Dirim B, Trudell DJ, Haghighi P, Resnick D (2009) Triceps brachii tendon: anatomic-MR imaging study in cadavers with histologic correlation. Skeletal Radiol 38:171–175. doi:10.​1007/​s00256-008-0605-6 PubMedCrossRef
19.
go back to reference Gabel GT, Zwahlen B, Morrey BF (1998) Surgical management of the extensor mechanism of the elbow. Instr Course Lect 47:151–156PubMed Gabel GT, Zwahlen B, Morrey BF (1998) Surgical management of the extensor mechanism of the elbow. Instr Course Lect 47:151–156PubMed
21.
go back to reference Bennett BS (1962) Triceps tendon rupture. J Bone Joint Surg Am 44:741–744 Bennett BS (1962) Triceps tendon rupture. J Bone Joint Surg Am 44:741–744
25.
go back to reference O’Driscoll SW (1992) Intramuscular triceps rupture. Can J Surg 35:203–207PubMed O’Driscoll SW (1992) Intramuscular triceps rupture. Can J Surg 35:203–207PubMed
29.
go back to reference Bos CFA, Nelissen RGHH, Bloem JL (1994) Incomplete rupture of the tendon of triceps brachii. A case report. Int Orthop 18:273–275PubMedCrossRef Bos CFA, Nelissen RGHH, Bloem JL (1994) Incomplete rupture of the tendon of triceps brachii. A case report. Int Orthop 18:273–275PubMedCrossRef
31.
go back to reference Levy M, Goldberg I, Meir I (1982) Fracture of the head of the radius with a tear or avulsion of the triceps tendon. A new syndrome? J Bone Joint Surg Br 64:70–72PubMed Levy M, Goldberg I, Meir I (1982) Fracture of the head of the radius with a tear or avulsion of the triceps tendon. A new syndrome? J Bone Joint Surg Br 64:70–72PubMed
33.
go back to reference Levy M, Fishel RE, Stern GM (1978) Triceps tendon avulsion with or without fracture of the radial head. A rare injury? J Trauma 18:677–679PubMedCrossRef Levy M, Fishel RE, Stern GM (1978) Triceps tendon avulsion with or without fracture of the radial head. A rare injury? J Trauma 18:677–679PubMedCrossRef
34.
go back to reference O’Driscoll SW, Morrey BF, Korinek S, An K (1992) Elbow subluxation and dislocation. A spectrum of instability. Clin Orthop 280:186–197PubMed O’Driscoll SW, Morrey BF, Korinek S, An K (1992) Elbow subluxation and dislocation. A spectrum of instability. Clin Orthop 280:186–197PubMed
36.
go back to reference Laseter JT, Russell JA (1991) Anabolic steroid-induced tendon pathology: a review of the literature. Med Sci Sports Exerc 23:1–3PubMed Laseter JT, Russell JA (1991) Anabolic steroid-induced tendon pathology: a review of the literature. Med Sci Sports Exerc 23:1–3PubMed
40.
go back to reference Clayton ML, Thirupathi RG (1984) Rupture of the triceps tendon with olecranon bursitis. Clin Orthop 184:183–185PubMed Clayton ML, Thirupathi RG (1984) Rupture of the triceps tendon with olecranon bursitis. Clin Orthop 184:183–185PubMed
41.
go back to reference Celli A, Arash A, Adams RA, Morrey BF (2005) Triceps insufficiency following total elbow arthroplasty. J Bone Joint Surg Am 87:1957–1964PubMedCrossRef Celli A, Arash A, Adams RA, Morrey BF (2005) Triceps insufficiency following total elbow arthroplasty. J Bone Joint Surg Am 87:1957–1964PubMedCrossRef
42.
go back to reference Gill DR, Morrey BF (1998) The Coonrad-Morrey total elbow arthroplasty in patients who have rheumatoid arthritis. A ten to fifteen-year follow-up study. J Bone Joint Surg Am 80:1327–1335PubMedCrossRef Gill DR, Morrey BF (1998) The Coonrad-Morrey total elbow arthroplasty in patients who have rheumatoid arthritis. A ten to fifteen-year follow-up study. J Bone Joint Surg Am 80:1327–1335PubMedCrossRef
43.
go back to reference Hildebrand KA, Patterson SD, Regan WD, MacDermid JC, King GJ (2000) Functional outcome of semiconstrained total elbow arthroplasty. J Bone Joint Surg Am 82:1379–1386PubMed Hildebrand KA, Patterson SD, Regan WD, MacDermid JC, King GJ (2000) Functional outcome of semiconstrained total elbow arthroplasty. J Bone Joint Surg Am 82:1379–1386PubMed
45.
go back to reference Morrey BF (1995) Complications of elbow replacement surgery. In: Morrey BF (ed) The elbow and its disorders, 2nd edn. Saunders, Philadelphia, pp 665–675 Morrey BF (1995) Complications of elbow replacement surgery. In: Morrey BF (ed) The elbow and its disorders, 2nd edn. Saunders, Philadelphia, pp 665–675
46.
go back to reference Ikävalko M, Belt EA, Kautiainen H, Lehto MUK (2004) Souter arthroplasty for elbows with severe destruction. Clin Orthop 421:126–133PubMedCrossRef Ikävalko M, Belt EA, Kautiainen H, Lehto MUK (2004) Souter arthroplasty for elbows with severe destruction. Clin Orthop 421:126–133PubMedCrossRef
47.
go back to reference Tsourvakas S, Gouvalas K, Gimtsas C, Tsianas N, Founta P, Ameridis N (2004) Bilateral and simultaneous rupture of the triceps tendon in chronic renal failure and secondary hyperparathyroidism. Arch Orthop Trauma Surg 124:278–280. doi:10.1007/s00402-003-0628-3 PubMedCrossRef Tsourvakas S, Gouvalas K, Gimtsas C, Tsianas N, Founta P, Ameridis N (2004) Bilateral and simultaneous rupture of the triceps tendon in chronic renal failure and secondary hyperparathyroidism. Arch Orthop Trauma Surg 124:278–280. doi:10.​1007/​s00402-003-0628-3 PubMedCrossRef
48.
go back to reference Murphy KJ, McPhee I (1965) Tears of major tendons in chronic acidosis with elastosis. J Bone Joint Surg Am 47:1253–1258PubMed Murphy KJ, McPhee I (1965) Tears of major tendons in chronic acidosis with elastosis. J Bone Joint Surg Am 47:1253–1258PubMed
49.
go back to reference Preston FS, Adicof A (1962) Hyperparathyroidism with avulsion of three major tendons. N Engl J Med 266:968–971PubMedCrossRef Preston FS, Adicof A (1962) Hyperparathyroidism with avulsion of three major tendons. N Engl J Med 266:968–971PubMedCrossRef
50.
go back to reference Chamseddine A, Jawish R, Aftimos G, Abiad R (1999) La rupture spontanée bilatérale simultanée du tendon quadricipital. Leb Med J 47:313–316 Chamseddine A, Jawish R, Aftimos G, Abiad R (1999) La rupture spontanée bilatérale simultanée du tendon quadricipital. Leb Med J 47:313–316
51.
go back to reference Martin JR, Wilson CL, Mathews WH (1958) Bilateral rupture of ligamenta patella in a case of disseminated lupus erythematosus. Arthritis Rheum 6:548–552CrossRef Martin JR, Wilson CL, Mathews WH (1958) Bilateral rupture of ligamenta patella in a case of disseminated lupus erythematosus. Arthritis Rheum 6:548–552CrossRef
52.
go back to reference Twinning LJ, Marcus WY, Garey JL (1964) Tendon ruptures in systemic lupus erythematosus. JAMA 187:120–124 Twinning LJ, Marcus WY, Garey JL (1964) Tendon ruptures in systemic lupus erythematosus. JAMA 187:120–124
53.
go back to reference Razzano CD, Wilde AH, Phalen GS (1973) Bilateral rupture of the infrapatella tendon in rheumatoid arthritis. Clin Orthop 91:158–161PubMedCrossRef Razzano CD, Wilde AH, Phalen GS (1973) Bilateral rupture of the infrapatella tendon in rheumatoid arthritis. Clin Orthop 91:158–161PubMedCrossRef
54.
go back to reference Kullman L, Wouters HW (1972) Muscle hemangioendothelioma causing rupture of the Achilles tendon. Clin Orthop 84:154–158CrossRef Kullman L, Wouters HW (1972) Muscle hemangioendothelioma causing rupture of the Achilles tendon. Clin Orthop 84:154–158CrossRef
55.
go back to reference Jorgensen F, Solgaard S (1982) Bilateral rupture of the triceps tendon in a patient receiving long-term hemodialysis. Ugeskr Laeger 144:2723PubMed Jorgensen F, Solgaard S (1982) Bilateral rupture of the triceps tendon in a patient receiving long-term hemodialysis. Ugeskr Laeger 144:2723PubMed
56.
go back to reference McCulloch PC, Spellman J, Bach BR Jr (2008) Familial triceps tendon ruptures. Orthopedics 31:600–602PubMedCrossRef McCulloch PC, Spellman J, Bach BR Jr (2008) Familial triceps tendon ruptures. Orthopedics 31:600–602PubMedCrossRef
58.
go back to reference Zionts LE, Vachon LA (1997) Demonstration of avulsion of the triceps tendon in an adolescent by magnetic resonance imaging. Am J Orthop 26:489–490PubMed Zionts LE, Vachon LA (1997) Demonstration of avulsion of the triceps tendon in an adolescent by magnetic resonance imaging. Am J Orthop 26:489–490PubMed
59.
go back to reference Viegas SF (1990) Avulsion of the triceps tendon. Orthop Rev 19:533–536PubMed Viegas SF (1990) Avulsion of the triceps tendon. Orthop Rev 19:533–536PubMed
60.
go back to reference Rood LK, Hevesy GZ (1991) An unusual complication of radial head fractures. Am J Emerg Med 9:553–554PubMedCrossRef Rood LK, Hevesy GZ (1991) An unusual complication of radial head fractures. Am J Emerg Med 9:553–554PubMedCrossRef
61.
go back to reference Shih-Wei L, Yu-Chung L (2007) Radial head fracture with neglected triceps tendon avulsion fracture: a case report. J Orthop Surg Taiwan 24:61–65 Shih-Wei L, Yu-Chung L (2007) Radial head fracture with neglected triceps tendon avulsion fracture: a case report. J Orthop Surg Taiwan 24:61–65
62.
go back to reference Rahmi M, Arssi M, Hattoma N, Doumane B, Largab A, Trafeh M (2002) Traumatic avulsion of the triceps tendon with fracture dislocation of the elbow. A case report. Pan Arab J Orthop Trauma 6:25–27 Rahmi M, Arssi M, Hattoma N, Doumane B, Largab A, Trafeh M (2002) Traumatic avulsion of the triceps tendon with fracture dislocation of the elbow. A case report. Pan Arab J Orthop Trauma 6:25–27
63.
go back to reference Abe Y, Rokkaku T, Imai K, Tokunaga S, Kuniyoshi K (2004) Triceps tendon rupture with avulsion fracture of the olecranon: a clinical report of three cases. J Jap Soc Surg Hand 21:700–704 Abe Y, Rokkaku T, Imai K, Tokunaga S, Kuniyoshi K (2004) Triceps tendon rupture with avulsion fracture of the olecranon: a clinical report of three cases. J Jap Soc Surg Hand 21:700–704
64.
65.
go back to reference Berthold M, Rikli DA (2002) Elbow dislocation with multidirectional instability; avulsion of the triceps tendon; and injury to the ulnar, median, and radial nerves: case report. J Trauma 53:1176–1178PubMedCrossRef Berthold M, Rikli DA (2002) Elbow dislocation with multidirectional instability; avulsion of the triceps tendon; and injury to the ulnar, median, and radial nerves: case report. J Trauma 53:1176–1178PubMedCrossRef
67.
go back to reference Daglar B, Delialioglu OM, Ceyhan E, Altas O, Bayrakci K, Gunel U (2009) Combined surgical treatment for missed rupture of triceps tendon associated with avulsion of the ulnar collateral ligament and flexor-pronator muscle mass. Strat Traum Limb Recon 4:35–39. doi:10.1007/s11751-009-0057-0 CrossRef Daglar B, Delialioglu OM, Ceyhan E, Altas O, Bayrakci K, Gunel U (2009) Combined surgical treatment for missed rupture of triceps tendon associated with avulsion of the ulnar collateral ligament and flexor-pronator muscle mass. Strat Traum Limb Recon 4:35–39. doi:10.​1007/​s11751-009-0057-0 CrossRef
68.
go back to reference Tasaki K, Saitoh O, Komiyama T, Morimoto R, Takayama S (2001) Triceps tendon rupture. J Jap Elbow Soc 8:163–164 Tasaki K, Saitoh O, Komiyama T, Morimoto R, Takayama S (2001) Triceps tendon rupture. J Jap Elbow Soc 8:163–164
69.
go back to reference Ring D, Gulotta L, Chin K, Jupiter JB (2004) Olecranon osteotomy for exposure of fractures and nonunions of the distal humerus. J Orthop Trauma 18:446–449PubMedCrossRef Ring D, Gulotta L, Chin K, Jupiter JB (2004) Olecranon osteotomy for exposure of fractures and nonunions of the distal humerus. J Orthop Trauma 18:446–449PubMedCrossRef
70.
go back to reference Kaempffe FA, Lerner RM (1996) Ultrasound diagnosis of triceps tendon rupture: a report of 2 cases. Clin Orthop 332:138–142PubMedCrossRef Kaempffe FA, Lerner RM (1996) Ultrasound diagnosis of triceps tendon rupture: a report of 2 cases. Clin Orthop 332:138–142PubMedCrossRef
71.
go back to reference Fritz RC, Steinbach LS (1996) Magnetic resonance imaging of the musculoskeletal system. Clin Orthop 324:321–339PubMedCrossRef Fritz RC, Steinbach LS (1996) Magnetic resonance imaging of the musculoskeletal system. Clin Orthop 324:321–339PubMedCrossRef
73.
go back to reference Strauch RJ (1998) Biceps and triceps injuries of the elbow. Orthop Clin North Am 30:95–107CrossRef Strauch RJ (1998) Biceps and triceps injuries of the elbow. Orthop Clin North Am 30:95–107CrossRef
74.
go back to reference Morrey BF, Regan WD (1994) Tendinopathies about the elbow. In: Delee JC, Drez D (eds) Orthopaedic sports medicine: principles and practice, vol. 1. Philadelphia, WB Saunders, pp 1231–1232 Morrey BF, Regan WD (1994) Tendinopathies about the elbow. In: Delee JC, Drez D (eds) Orthopaedic sports medicine: principles and practice, vol. 1. Philadelphia, WB Saunders, pp 1231–1232
75.
go back to reference Inhofe PD, Moneim MS (1996) Late presentation of triceps rupture. A case report and review of the literature. Am J Orthop 25:790–792PubMed Inhofe PD, Moneim MS (1996) Late presentation of triceps rupture. A case report and review of the literature. Am J Orthop 25:790–792PubMed
76.
go back to reference Pina A, Garcia I, Sabater M (2002) Traumatic avulsion of the triceps brachii. J Orthop Trauma 16:273–276PubMedCrossRef Pina A, Garcia I, Sabater M (2002) Traumatic avulsion of the triceps brachii. J Orthop Trauma 16:273–276PubMedCrossRef
77.
go back to reference Tsourvakas S, Alexandropoulos C, Gouvalas K, Gimtsas C, Tsianas N, Founta P (2005) Spontaneous major tendon ruptures in patients on chronic hemodialysis. Eur J Orthop Surg Traumatol 15:109–112. doi:10.1007/s00590-004-0213-7 CrossRef Tsourvakas S, Alexandropoulos C, Gouvalas K, Gimtsas C, Tsianas N, Founta P (2005) Spontaneous major tendon ruptures in patients on chronic hemodialysis. Eur J Orthop Surg Traumatol 15:109–112. doi:10.​1007/​s00590-004-0213-7 CrossRef
78.
go back to reference Levy M (1987) Repair of triceps tendon avulsions or ruptures. J Bone Joint Surg Br 69:115PubMed Levy M (1987) Repair of triceps tendon avulsions or ruptures. J Bone Joint Surg Br 69:115PubMed
79.
go back to reference Anderson KJ, LeCocq JF (1957) Rupture of the triceps tendon. J Bone Joint Surg Am 39:444–446PubMed Anderson KJ, LeCocq JF (1957) Rupture of the triceps tendon. J Bone Joint Surg Am 39:444–446PubMed
Metadata
Title
Ruptures and avulsions of the distal tendon of the triceps brachii
Authors
Ali Hassan Chamseddine
Roger M. Jawish
Abdallah A. Alasiry
Hadi K. Zein
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 3/2012
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-011-0818-6

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