Distal Triceps Rupture with an Injury of the Medial Ulnar Collateral Ligament: a Result of a Fall Onto an Outstretched Arm - a Case Series

Abstract

Traumatic triceps tendon ruptures are rare and known to result in substantial disability unless appropriate surgical treatment is performed. A traumatic rupture can occur due to a fall onto the outstretched hand. Tearing of the triceps tendon results in a valgus load onto the elbow, which can lead to injuries to the radial head/neck and/or the ulnar collateral ligament. Hence, attention must be paid to associated pathologies after diagnosis of rupture to the distal triceps tendon. Our surgical procedure in these cases includes diagnostic arthroscopy to detect concomitant injuries. In the following, we present three cases where we performed an open suture bridge repair of the triceps tendon followed by suture repair of the ulnar collateral ligament. All patients recovered well and reported no elbow pain or limited range of motion. The ASES and Mayo Elbow Performance scores were 100 at the 1-year follow-up.

Zusammenfassung

Traumatische distale Trizepssehnenverletzungen sind seltene Verletzungen. Nichtsdestotrotz ist die korrekte Therapie entscheidend für die Funktion des Armes. Der Sturz auf den ausgestreckten Arm kann die Ursache sein. Die Ruptur der Sehne im Unfallmoment verändert die Krafteinwirkung, sodass Begleitverletzungen wie die Radiuskopffraktur oder der Riss des medialen, ulnaren Kollateralbandes nicht selten sind. Daher sind mögliche Begleitverletzungen bei einer distalen Trizepssehnenruptur dezidiert zu prüfen. Gemäß unserem Vorgehen kann neben der MRT-Diagnostik eine Arthroskopie hilfreich sein, um mögliche Begleitpathologie adäquat zu erfassen und zu adressieren. Im Folgenden werden drei Fälle vorgestellt, die operativ mittels Trizepssehnen-Naht sowie Refixation des medialen ulnaren Kollateralbandes versorgt wurden. Das 1-Jahres-Followup zeigte keine Bewegungseinschränkungen oder Instabilitäten, der ASES- und Mayo Elbow Score waren 100.

Keywords

Triceps tendon - ulnar collateral ligament - eccentric load - technical note

Schlüsselwörter

Trizepssehne - ulnares Kollateralband - exzentrische Krafteinwirkung - Operationstechnik

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