Abstract
Triceps tendon avulsion is a rarely occurring tendinous injury. Various surgical procedures, such as repair using sutures through the transosseous tunnel or suture anchors, have been reported for treating triceps tendon avulsion. However, standard surgical treatment has not yet been established. Here, we present a case of triceps tendon avulsion treated using the suture bridge technique. A 58-year-old man who fell on his left elbow from standing height presented to our hospital. Plain radiography revealed an avulsion fracture of the left olecranon process, suggesting triceps tendon avulsion. We performed surgical repair of the avulsed bone fragments and ruptured triceps tendon. We inserted suture anchors into the ulna, proximal to the fracture site, and passed the sutures through the full thickness of the triceps. Subsequently, fracture fragments were reduced and fixed by pulling them together with the triceps. We inserted knotless anchors into the ulna distal to the fracture site and fixed the avulsed bone fragments and triceps tendon using the suture bridge technique. The patient recovered well in five months and reported no elbow pain or limited range of motion. This suture bridge technique is advantageous as it prevents iatrogenic fracture and knot irritation, and it would be indicated in cases with poor bone quality or thin skin soft tissue of the olecranon.
Highlights
Since the site of rupture is most commonly located at osseous insertion, patients with triceps tendon rupture often present with avulsion fractures of the olecranon process [3]
We present a case of triceps tendon avulsion, wherein we used the suture bridge technique, which is often performed for avulsion fractures of the greater tuberosity
With the elbow kept in the reduced position of 45° of flexion, we inserted two Quattro® Link Knotless anchors (Zimmer Biomet, Warsaw, IN, USA) into the ulna distal to the fracture site and fixed the dislocated bone fragments using the suture bridge technique (Figure 2(c))
Summary
Triceps tendon rupture occurs rarely, accounting for less than 0.8% of all upper limb tendon injuries [1]. The injury is thought to be caused by eccentric load on the triceps during a fall on an outstretched arm [2]. Since the site of rupture is most commonly located at osseous insertion, patients with triceps tendon rupture often present with avulsion fractures of the olecranon process [3]. Tears involving >50% of the tendon or complete ruptures are considered an indication for surgical treatment [2, 4]. We present a case of triceps tendon avulsion, wherein we used the suture bridge technique, which is often performed for avulsion fractures of the greater tuberosity
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