Triceps tendon rupture: repair and rehabilitation

Abstract

Triceps tendon ruptures are rare injuries and are frequently missed on initial presentation to the emergency department. In cases of complete rupture, surgical repair is recommended but no guidelines exist on the optimum reconstructive technique or rehabilitation. We present a surgical technique and rehabilitation programme for the management of these injuries. A midline posterior incision is performed, the ruptured triceps tendon is identified and mobilized, and the tendon footprint is prepared. The tendon is then repaired using bone suture anchors, with a parachute technique, and held in 40° of flexion. The rehabilitation programme is divided into five phases, over a period of 12 weeks. Range of movement is gradually increased in a brace for the first 6 weeks. Rehabilitation is gradually increase in intensity, progressing from isometric extension exercises to weight-resisted exercises, and finally plyometrics and throwing exercises. Our surgical technique provides a solid tendon repair without the need for further metalwork removal. The graduated rehabilitation programme also helps to protect the integrity of the repair at the same time as enabling patients to gradually increase the strength of the triceps tendon and ultimately return to sport activities.

Bench, Bar, and Ring Dips: Do Kinematics and Muscle Activity Differ?

“…While the peak activation intensity of TB is significantly less than during the bar and ring dips, the bench does target the TB relatively well when considering the reduced resistance through the upper limb, the overall movement complexity, and the relatively low activation of other prime movers (PM and AD). The dip is often called the “triceps dip” [ 4 , 8 ], which appears appropriate for the bench dip but remains unclear for other variations according to this investigation’s findings. Previous research has compared the activation intensity of TB when completing eight common TB exercises and concluded that the bench dip, triangle push-up and triceps kickback exercises exhibited the equally greatest TB activation intensity [ 28 ].…”

“…More recently, ring dips have been popularised as another dip variation primarily aiming to increase the stabilization requirements and thereby increase muscular demands of the upper limb and trunk while performing the movement [ 7 ]. Further to these examples, the dip (no specified variation) has been used in physician’s protocols to rehabilitate TB [ 8 ] and PM [ 9 ] ruptures and improve swimming performance [ 10 ]. Yet, the prescription of the dip in these various performance and rehabilitation programs is based on the practitioner’s experience rather than empirical evidence.…”

Rotura Aguda do Tendão Tricípite Braquial no Atleta: Lesão Rara e por Vezes Esquecida

“…Outros autores defendem a imobilização do cotovelo em 40° de extensão durante duas semanas para permitir a cicatrização inicial, seguido do aumento gradual da amplitude de movimento. 13 O nosso protocolo evidenciou-se eficaz pelo facto de ambos os atletas apresentarem mobilidades completas às três semanas e retomarem a atividade desportiva aos níveis prévios ao da lesão, sem evidência de recorrência da mesma.…”

Distale Bizepssehnen- und Trizepssehnenrupturen

“…Die postoperative Behandlung ist von der angewandten Operationstechnik abhängig. Generell kann jedoch folgendes Nachbehandlungsschema empfohlen werden [68]…”