Lee Hunter MD, MBA (Hunter Medical Founder and Chief Medical Officer)

November 2019

Acute triceps tendon ruptures are generally straightforward to repair. Chronic triceps tears however often require allografts to help bridge the defect caused by tendon retraction.

62 YOM with Chronic Triceps Tendon Avulsion

The patient presented to my office 6 weeks after a fall onto his left arm, complaining of persistent elbow pain and weakness. An MRI confirmed a triceps tendon rupture with significant retraction. Having just undergone contralateral rotator cuff surgery, he declined surgery for his triceps tear at that point. Ultimately, he returned to my office 6 months after his injury and subsequently underwent triceps reconstruction with a hamstring allograft. His pre-operative x-rays and initial MRI are below.

The Procedure:

he patient was positioned supine utilizing the ElbowLOC® Arm Positioning System. A standard posterior approach was made. The ulnar nerve was identified, decompressed, and protected. The triceps tendon stump was mobilized with the help of relaxing fascial incisions bilaterally. A hamstring allograft was prepared and woven through the native triceps stump, leaving equal limbs on either side. A 5.5 mm transverse bone tunnel was created in the olecranon, and the allograft limbs passed bidirectionally through it. The elbow was then held statically extended by the positioner while the allograft was tensioned and woven back through the native triceps, secured with fiberwire. A hinged elbow brace with a 45 degree flexion block was applied. Operative photos are below.

Supine Triceps Allograft Reconstruction(Gallery)

Supine positioning for elbow surgery is optimum for the patient and the surgeon, not to mention quicker and easier for the surgical team. The ElbowLOC® Supine Positioner is the only arm positioner that gives the surgeon the ability to “dial in” the desired amount of elbow extension while allowing unencumbered access to the forearm. This makes triceps tendon repairs and reconstructions technically easier to perform. This case is another great example of how the ElbowLOC® simplifies and accelerates procedural times for many elbow surgeries and makes surgery easier for the surgeon, patient, and staff!