Triceps lesions and ruptures

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