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Triceps Rupture

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Topic updated on 09/16/14 12:35pm
Introduction
  • Epidemiology
    • demographics
      • usually males
      • age 30-50 most common
      • commonly seen in
        • competitive weightlifting
        • body building
        • football players
    • risk factors 
      • systemic illness (renal osteodystrophy)
      • anabolic steroid use
      • local steroid injection 
      • flouroquinolone use
      • chronic olecranon bursitis
      • previous triceps surgery
  • Pathophysiology
    • mechanism
      • usually forceful eccentric contraction
    • pathoanatomy
      • rupture most common at the insertion of medial or lateral head
      • less frequently through muscle belly or musculotendinous junction
Presentation
  • History
    • patients often note a painful pop
  • Symptoms
    • loss of ability to extend elbow against gravity
  • Physical exam
    • may have palpable gap
    • swelling, ecchymosis, and pain
Imaging
  • Radiographs
    • recommended views
      • AP/lateral of elbow
    • findings
      • may show "flake sign" on lateral view  
  • MRI
    • useful for determining location and severity 
Treatment
  • Non-operative
    • supportive treatment
      • indications
        • partial tears and able to extend against gravity
        • low demand patients in poor health
  • Operative
    • primary surgical repair
      • indications
        • acute complete tears
        • partial tears (>50%) with significant weakness
      • technique
        • delayed reconstruction may need tendon graft 
Complications
  • Elbow stiffness
  • Ulnar nerve injury
  • Failure of repair

 

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Qbank (2 Questions)

TAG
(OBQ11.135) A 40 year-old competitive weightlifter felt a painful pop in his elbow while performing a bench press. His lateral radiograph is shown in Figure A. An MRI is likely to show which of the following? Topic Review Topic
FIGURES: A          

1. Distal biceps tendon rupture
2. Brachialis muscle rupture
3. Lateral ulnar collateral ligament tear
4. Medial ulnar collateral ligament tear
5. Triceps tendon tear

PREFERRED RESPONSE ▶
TAG
(OBQ05.266) Triceps ruptures are associated with all of the following EXCEPT? Topic Review Topic

1. Anabolic steroid use
2. Local corticosteroid injection
3. Renal osteodystrophy
4. Fluoroquinolone use
5. Creatine supplement use

PREFERRED RESPONSE ▶




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