Acute Triceps Tendon Repair: A Technique Utilizing 3 Curved Tunnels and Proximal Knots

Abstract

Although triceps tendon tears are less common than other tendon tears, complete ruptures require surgical repair to restore the strength of the extensor mechanism of the elbow. There are several described techniques for repair using both transosseous tunnels and suture anchors. Current techniques often result in large suture knots over the dorsal ulna under thin subcutaneous tissue, which can be irritating for patients. Knotless techniques require costly suture anchors. In this technical note, we describe a novel transosseous 3-tunnel technique with proximal suture knots to lessen the potential for postoperative pain.

Clinical Outcomes of Low-Cost, Anchorless Repair of the Triceps Tendon Using a Proximal Knot Technique

“…These knot stacks could be identified on physical examination, but no Reprinted with permission from Sarokhan and Leung. 13 OUTCOMES OF PROXIMAL KNOT TRICEPS REPAIR e3 patient noticed their presence or requested knot-stack removal.…”

“…at 1 institution. All patients aged between 18 and 85 years who experienced isolated, acute, insertional triceps tears fixed with bone tunnels and proximal knots as described by Sarokhan and Leung 13 were included. The exclusion criteria included chronic injury, enthesophyte removal, ipsilateral biceps injury, and myotendinous rupture.…”

“…The surgical technique as described by Sarokhan and Leung 13 was used. The patient was placed in the supine position after administration of regional anesthesia.…”

“…Recent literature has described a transosseous repair with proximal knots tied over the triceps tendon, with the goal of minimizing the potential for symptomatic prominent suture knots without the added cost of anchors. 13 Although favorable results have been published for numerous other methods, 6,14 a clinically superior technique has yet to be proved. The purpose of our study was to use validated outcome measures to evaluate the clinical results of surgical repair of distal triceps tendon ruptures using transosseous tunnels and high-strength sutures with proximally based knots.…”

All-Suture Anatomic Footprint Repair of the Distal Triceps Tendon

“…Surgical treatment is the standard of care for triceps injuries in active individuals. Options for repair include transosseous, 1 , 2 , 3 , 4 , 5 , 6 , 7 suture anchor (SA), 1 , 2 , 4 , 8 , 9 and hybrid transosseous-SA techniques. 3 , 5 , 6 , 10 The transosseous cruciate (TC) technique has been the historical standard for treatment of these injuries.…”