Clinical Outcome Measures Following Suture Anchor Repair for Traumatic Rupture of the Distal Triceps Tendon (SS-53)

Abstract

Introduction Rupture of the triceps tendon is an uncommon injury with few published reports of surgical repairs. These publications include case reports and small series, which assess elbow strength and motion, but fail to report any commonly used or validated elbow outcome measures for the patients. These reports all utilize braided polyester sutures through bone tunnels in the olecranon for the reattachment of the distal triceps tendon. While recent publications have described the surgical technique and biomechanical properties of distal triceps tendon repair using suture anchors, there are no published outcomes using this technique. The purpose of this study is to report the clinical outcomes following suture anchor repair of the ruptured triceps tendon with high strength sutures. An extensive literature review failed to identify any other report which evaluated the clinical results using validated elbow outcome measures or to report the clinical results following distal triceps suture anchor repair. Methods A consecutive series of traumatic distal triceps tendon ruptures from a single institution between 2006 and 2010 was reviewed. All cases were surgically repaired using suture anchors and high strength sutures. The patients were evaluated postoperatively using the Disabilities of the Arm, Shoulder, and Hand (DASH) outcome measure, the Oxford Elbow Score, the American Shoulder and Elbow Surgeons (ASES) elbow assessment form, and the Mayo Elbow Performance index. Results A total of five male patients with at least six months follow-up underwent suture anchor repair for traumatic rupture of the distal triceps tendon. Of the five distal triceps tendon tears, three involved the dominant arm and two involved the non-dominant arm. The average patient age was 46.8 years (range, 35 to 54) and the average follow-up was 27.4 months (range 6 to 49 months). Postoperatively, the mean DASH score was 2.2 (from 0-100, lower score indicates less disability and better function), the mean ASES elbow score was 99.2 (from 0-100, higher score indicates better outcome), the mean Mayo Elbow Performance Index was 95.8 (from 0-100, higher score indicates better outcome), the mean Oxford Elbow Pain Score was 98.8 (from 0-100, higher score indicates less pain and better outcome), the mean Oxford Elbow Function Score was 100 (from 0-100, higher score indicates better function), and the mean Oxford Elbow Social Score was 96.2 (from 0-100, higher score indicates better outcome). Conclusion Distal triceps tendon ruptures can be successfully repaired using high strength sutures in suture anchors instead of conventional sutures in bone tunnels. This technique results in minimal pain and excellent elbow function based on validated clinical outcome measures.