Distal Biceps and Triceps Injuries

Abstract

Background:Rupture of the distal biceps and triceps tendons are relatively uncommon injuries typically occurring in middle-aged males as a result of eccentric loading of the tendon.Methods:A literature search was performed and the authors’ personal experiences reported.Results:This review discusses the diagnosis, indications and guidelines for management of these injuries and provides a description of the authors’ preferred operative techniques.Conclusion:Whilst non-operative treatment may be appropriate for patients with low functional demands, surgical management is the preferred option for the majority of patients. We have described a cortical button technique and osseous tunnel technique utilised at our institution for distal biceps and triceps tendon fixation respectively. For biceps or triceps tendon injuries, those receiving an early diagnosis and undergoing surgical intervention, an excellent functional outcome can be expected.

Top 15 musculoskeletal lesions in the aging recreational sporter: a pictorial review

“…Rupture of the distal brachii occur in middle-aged male with a peak at around 50 years of age ( 50 ). Bodybuilders particularly those using anabolic steroids are at risk ( 50 ).…”

“…Patients typically present with a history of marked pain on eccentric loading accompanied by a popping sound. Subsequent symptoms are pain, bruising at the antecubital fossa and weakness in elbow flexion and/or forearm supination ( 50 ). Clinical examination may reveal an abnormal contour of the distal biceps ( 50 ).…”

“…Subsequent symptoms are pain, bruising at the antecubital fossa and weakness in elbow flexion and/or forearm supination ( 50 ). Clinical examination may reveal an abnormal contour of the distal biceps ( 50 ). Tears may be either partial or complete.…”

Surgical repair of distal triceps rupture: a systematic review of outcomes and complications

“…20,21 Rupture is typically caused by trauma or physical strain with heavy eccentric loading, such as falling on an outstretched hand, or in sports like weight lifting. 5,20 Ruptures usually occur at the muscle bone conjoint, although intramuscular ruptures have been reported as well. 20 A clinical finding that suggests possible injury includes a palpable gap proximal to the olecranon, where the tendon would be, although swelling and inflammation may mask this.…”

“…Another indicator is the flake sign seen on lateral elbow radiographs, signifying an avulsion fracture at the olecranon. 5 Treatment options include nonoperative management or surgical repair, commonly with transosseous bone tunnels (TBTs) or suture anchors (SAs). Nonoperative management is associated with a deficit in extension strength and a longer recovery time and is usually only considered in patients with small partial tears, low-demand patients, or high-risk patients who cannot tolerate repair.…”