Presentation
Fall on the ground while walking resulting in the posterior elbow injury. Complaining of local swelling, painful and restricted elbow extension.
Patient Data
Discontinuity of the triceps tendon's superficial (posterior) fibres formed by the lateral and the long heads. Avulsed tendon fibres show 30 to 35 mm retraction with a small bone flake. Intact deeper(anterior) fibres represent the triceps medial head tendon.
Short-axis cine-loop runs from the proximal to the distal direction.
Not artistic but a simple quick drawing gives a better understanding of the pathology. It was attached to the report.
A side-view photo of the elbow shows a small depression just proximal to the elbow tip. There is a bulge proximal to it. Torn superficial fibres are reflected. Deeper fibres were intact. The torn tendon was fixed to the olecranon footprint using two double-loaded anchors. Post fixation IITV image photos of lateral and frontal views show satisfactory anchor position.
Post-operative one-month scan aligned to the triceps long axis. The repaired tendon reaches up to the ulnar olecranon insertion site. Sutures in the tendon substance. Anchor defect in the ulnar olecranon cortex. No collection. 2nd cine loop shows tendon continuity during resisted elbow extension. These are expected postoperative findings.
Case Discussion
The patient developed posterior elbow pain, swelling, and restricted elbow extension after a fall on the ground. The clinical examination revealed a palpable defect at the triceps tendon location. Lateral elbow radiograph (not uploaded, no copyright) revealed a bone flake in the posterior elbow. The clinically suspected triceps tendon tear was confirmed by the ultrasound. The ultrasound findings of a torn superficial tendon and an intact deeper tendon were confirmed during the surgery. The torn tendon was repaired using anchors.
Intraoperative photos courtesy: operating surgeon Dr. Nisarg A. Patel
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