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Triceps lesions and ruptures

Contents

Lesions of triceps

Definition

  • Lesions of the triceps muscle are rare
  • Triceps tendinopathy and rupture constitute the least common type of elbow tendinopathy1

Occurrence

  • Male predominance

Causes

  • Overuse and repetitive heavy lifting2

 

Localizations

  1. Musculotendinous junction (most common)3
  2. Body of the tendon
  3. Tenoperiosteal/tendon-osseus junction at the olecranon4

Risk factors

  • Metabolic conditions
  • Endocrine disorders
    • Diabetes mellitus5
    • Hypoparathyroidism6
  • Corticosteroid injection7
  • Anabolic steroids
  • Overtraining

Indications

  • Patient complains of pain and/or weakness with activities of elbow extension

Examination

  • Resisted extension of elbow is painful and possibly weak
  • Palpation is tender at the triceps insertion on the olecranon

Total or partial ruptures of triceps

Definition

  • Rare injury with either a complete or partial rupture of the tendon

Occurrence

  • Male predominance
  • Patients of all ages

Causes

  • Triceps avulsions from the olecranon or intratendinous ruptures are the result of traumatic injuries
  • Acute and traumatic injuries
    • Such as fall onto a outstretched hand with resulting violent eccentric load absorbed by the triceps muscle

Risk factors

  • Softball
  • Skiing
  • Football
  • American football
  • Weightlifting were also avulsion fracture occurs as well
    • Rare occurrence
  • Metabolic conditions
  • Endocrine disorders
    • Diabetes mellitus8
    • Hypoparathyroidism9
  • Corticosteroid injection10
  • Anabolic steroids
  • Overtraining
  • Olecranon bursitis

 

Examination

  • Palpable gap is possible to distinguish just proximal to the olecranon
  • Resisted extension – complete weakness
    • Even if there is not complete weakness it does not exclude the diagnosis (partial tear, lateral expansion of the triceps fascia is affected)
  • Swelling, tenderness, bruising

 

Treatment

  • Surgical repair if complete tear or avulsion fractures11
    • Complete ruptures are usually have the best results when performed within 3-4 weeks of the injury
  • Incomplete tears can be managed conservatively with splint immobilization for 4 weeks in 30 degree of flexion12
    • It has been reported that 6 of 10 partial triceps teras in professional football players with no lingering effects, such as pain or dysfunction after healing 13

References

  1. https://www.ncbi.nlm.nih.gov/pubmed/13635217/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435941/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435941/
  4. https://www.ncbi.nlm.nih.gov/pubmed/16414484/
  5. https://pubmed.ncbi.nlm.nih.gov/9195438/
  6. https://pubmed.ncbi.nlm.nih.gov/3673545/
  7. https://pubmed.ncbi.nlm.nih.gov/9593095/
  8. https://pubmed.ncbi.nlm.nih.gov/9195438/
  9. https://pubmed.ncbi.nlm.nih.gov/3673545/
  10. https://pubmed.ncbi.nlm.nih.gov/9593095/
  11. https://pubmed.ncbi.nlm.nih.gov/14563805/
  12. https://pubmed.ncbi.nlm.nih.gov/20044490/
  13. https://pubmed.ncbi.nlm.nih.gov/14977669/