Elbow Tendon Injury and Repair: Triceps and Biceps Tendons

Triceps tendon injuries are probably among the rarest tendon injuries in the human body. Evidence shows male predominance (3:1, male to female) with wide age variance at occurrence. The most common rupture site is at tendon insertion into the olecranon and more rarely at the myotendinous junction or intramuscularly. Several triceps tendon injuries risk factors have been reported. The main injury mechanism is falling on an outstretched hand. Other conditions that can increase risk of triceps ruptures are: sport activities, use of anabolic steroid drugs or local steroid injection, olecranon bursitis. Alternatively, risk of triceps ruptures can arise secondary to surgical exposure (such as following total elbow replacement) or secondary to release for stiff elbow. Conservative management plays a role in partial triceps injuries involving the muscle belly or musculotendinous junction, or in partial ruptures of the distal tendon insertion when there is no significant extension power loss against gravity and no resistance according to the patient’s age and lifestyle. Several surgical techniques and different approaches offer variable options for the surgical management of acute complete or chronic tears as direct olecranon repair, augmentation with auto- or allograft, anconeus rotation flap, Achilles tendon allograft with or without calcaneus bone.