The triceps muscle is the large muscle on the back of the
upper arm.
The triceps muscle is a powerful extensor of the elbow
joint. The triceps muscle has three head: long head, lateral head and medial
head. All three head of the triceps muscle share a common tendon that inserts
into the olecranon process at the elbow.
A triceps tendon rupture is an injury that occurs to the
triceps tendon in the back of the elbow. This is injury can be missed in a lot
of patients. Rupture of the triceps muscle typically occurs in male athletes
such as body builders, football players and in athletes who lift heavy weights.
A triceps tendon rupture is the tear of the tendon that
attaches the triceps muscle to the ulna. Rupture of the tendon can be complete or incomplete. Common mechanism of injury include: stress from sudden
increase in intensity of training, direct trauma to the tendon, and laceration
of the tendon. Rupture of the tendon may also occur due to local steroid
injection or it may be due to a history of anabolic steroid use. Rupture may
also occur due to previous elbow surgery or systemic diseases such as renal
diseases and gout.
There will be a painful limitation of range of motion and
the patient will be unable to extend the elbow against resistance. The patient
may hear a pop and the tendon may retract upwards. A gap may be felt in the
back of the elbow where the rupture occurs.
X-rays may show a bony avulsion. The flake sign identifies
avulsion on lateral x-ray. X-rays are helpful for diagnosing a triceps tendon
rupture, however MRI is the best study to visualize the tear.
Treatment:
Establishing the correct diagnosis early is important. Early
repair of the tendon in acute cases with delay in diagnosis, primary repair of
the tendon may not be possible and the patient may require tendon
reconstruction with a less favorable outcome. Reconstruction of the tendon by a
graft in chronic neglected cases, especially if the patient has a major
disability in elbow extension.
