上腕三頭筋けん断裂に対する再建術

Abstract

Rupture of the triceps tendon is a rare injury, and has been reported as the least common of all tendon injuries. We report 2 cases, reconstructed by use of the fascia of the extensor muscle in the forearm combined with additional free tensor fascia lata tendon graft. The patients were a 43-year-old male and a 18-year-old male complaining of insufficient elbow extension after trauma. They could not extend the elbow against gravity. Surgical exposure revealed a complete rupture of the triceps tendon and a defect at the insertion. The proximal end of the tendon did not assume a normal appearance. The scar at the defect and the proximal end of the triceps tendon was refected. A flap of fascia was raised from the extensor muscle of the forearm, left attached to the base of the olecranon, reflected from distal to proximal, and sutured to the distal triceps tendon. We additionally covered it with the free tensor fascia lata tendon to reinforce the strength and smooth the gap. About one year after surgery, both patients recovered sufficient strength of elbow extension. One of the patients, who is a farmer, is now capable of vigorous push-ups. Both patients have returned to work as a farmer and a cook. This method is useful for rupture of the triceps tendon with defect.