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J Am Acad Orthop Surg, Vol 18, No 1, January 2010, 31-40.
© 2010 the American Academy of Orthopaedic Surgeons
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Distal Triceps Rupture

Peter C. Yeh, MD, Seth D. Dodds, MD, L. Ryan Smart, MD, Augustus D. Mazzocca, MS, MD and Paul M. Sethi, MD

From the Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT (Drs. Yeh and Dodds), New England Baptist Hospital, Boston, MA (Dr. Smart), the University of Connecticut, Farmington, CT (Dr. Mazzocca), and Orthopaedic and Neurosurgery Specialists PC and the ONS Foundation for Clinical Research and Education, Greenwich, CT (Dr. Sethi).

Dr. Dodds or an immediate family member is a member of a speakers’ bureau or has made paid presentations on behalf of Integra and Medartis, and serves as a paid consultant to or is an employee of Replication Medical. Dr. Mazzocca or an immediate family member is a member of a speakers’ bureau or has made paid presentations on behalf of, serves as a paid consultant to or is an employee of, and has received research or institutional support from, Arthrex. Dr. Sethi or an immediate family member has received royalties from, is a member of a speakers’ bureau or has made paid presentations on behalf of, and has received research or institutional support from Arthrex. Neither of the following authors nor an immediate family member has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Yeh and Dr. Smart.

Distal triceps rupture is an uncommon injury. It is most often associated with anabolic steroid use, weight lifting, and laceration. Other local and systemic risk factors include local steroid injection, olecranon bursitis, and hyperparathyroidism. Distal triceps rupture is usually caused by a fall on an outstretched hand or a direct blow. Eccentric loading of a contracting triceps has been implicated, particularly in professional athletes. Initial diagnosis may be difficult because a palpable defect is not always present. Pain and swelling may limit the ability to evaluate strength and elbow range of motion. Although plain radiographs are helpful in ruling out other elbow pathology, MRI is used to confirm the diagnosis, classify the injury, and guide management. Incomplete tears with active elbow extension against resistance are managed nonsurgically. Surgical repair is indicated in active persons with complete tears and for incomplete tears with concomitant loss of strength. Good to excellent results have been reported with surgical repair, and very good results have been achieved even for chronic tears.






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Copyright © 2010 by the American Academy of Orthopaedic Surgeons.