Triceps Tendon Repair

Dr. Garcia demonstrates his technique for triceps tendon repair

Anatomy:

The triceps tendon is a combination of 3 major muscle in the back of the humerus. The muscle connects the shoulder to the elbow. With this tendon you are elbow to extend your arm. A full tear of the triceps tendon is a rare injury but if it does occur it should be treated promptly. You can also have partial tears of the tendon. If you are athletic and tear more than 50% of the tendon, surgery is generally recommended.

How does it occur?

This tendon can rupture from weight lifting or during intense activities. High impact sports puts athletes at a higher risk of tearing this when falling on an outstretched arm. Sometimes some of the bone of the elbow pulls off as well, called an avulsion.

Presentation:

Patients present with weakness extending their elbow. In partial tears, patients may be able to extend their elbow but it is significantly weaker than their other arm. With regards to their full tears, patients can not extend their elbow. Usually there is significant bruising behind the elbow and you can feel gap between the elbow bone and the triceps muscle.

Evaluation and Treatment:

Evaluation of these injuries is needed promptly. Dr. Garcia will evaluate your elbow and check an x-ray for any other injuries. A thorough nerve physical exam is performed as well to make sure the elbow nerves are not involved. An MRI will be ordered to determine the extent of the damage to the tendon and help develop a treatment plan.

Surgery:

Almost all triceps tendon ruptures need surgery and usually these require immediate attention. Surgery is performed to the back of the elbow. The tendon is mobilized and repaired back to the olecranon where it attaches. Small sutures and anchors are used to secure the tendon back to its anatomic position. For chronic injuries, Dr. Garcia may use a tendon graft from a cadaver or a newer technique involving a skin graft patch to improve healing of the tendon. These grafts are used in cases where the tendon has been torn for too long and cannot be pulled back to the bone safely.

Recovery:

Success rates and return to sports is very good for triceps tendon repairs. The elbow is placed in an elbow brace in near full extension for 2-4 weeks depending on how retracted the tendon was during surgery. After this, the dressing is changed and gradual physical therapy is performed to improve motion and eventually strength. For more information on physical therapy and recovery see Dr. Garcia’s postoperative rehab protocols sections.