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Triceps Tendon Rupture S53.429A 841.3

triceps tendon rupture xray

elbow bony anatomy

triceps tendon rupture mri

synonyms: triceps avulsion, triceps tendon avulsion, triceps rupture

Triceps Rupture ICD-10

 

A- initial encounter

D- subsequent encounter

S- sequela

Triceps Rupture ICD-9

  • 841.3 (Sprains and strains of ulnohumeral joint; includes rupture of tendon; excludes open laceration of tendon)
  • 881.21 (open wound of elbow with tendon involvement)

Triceps Rupture Etiology / Epidemiology / Natural History

  • Rare
  • Generally men.
  • Can occur from fall on outstretched arm, direct blow, laceration, or deceleration stress on a contracted triceps.
  • MOI: deceleration force applied against an actively contracting triceps muscle.
  • May occur spontaneoulsy with systemic diseases: hyperparathyroidism, or with chronic steriods for SLE.

Triceps Rupture Anatomy

  • Distally the triceps tendon consists of two bands that join together above the elbow and insert into the posterior portion of the dorsal surface of the olecranon.
  • The lateral band extends over the anconeus muscle inserting into the dorsal fascia of the forearm.

Triceps Rupture Clinical Evaluation

  • Palpable depression just proximal to the olecranon. May have swelling and posterior ecchymosis.
  • May continue to have active elbow extension due to the intact lateral expansion of the triceps with the anconeus.

Triceps Rupture Xray / Diagnositc Tests

Triceps Rupture Classification / Treatment

  • Acute: primary repair indicated. Nonabsorbable suture placed through drill holes in the olecranon, consider hamstring autograft augmentation (Weistroffer JK, JSES 2003;12:193).
  • Chronic: Triceps repair with augmentation. Consider anconeus rotation flap, or Achilles tendon allograft, or hamstring allo/autograft (Weistroffer JK, JSES 2003;12:193).
  • CPT = 24341 (repair, tendon or muscle, upper arm or elbow, each tendon or muscle)

Triceps Rupture Associated Injuries / Differential Diagnosis

Triceps Rupture Complications

  • Rerupture
  • Infection
  • Stiffness / flexion contracture
  • CRPS
  • HO
  • Compartment Syndrome (Brumback RJ, JBJS 1987;69A:1445)

Triceps Rupture Follow-up Care

  • Posterior splint in 40° of flexion for 2-3 weeks.
  • 3weeks: start active ROM exercises
  • 6weeks: progressive strengthening.
  • Full recovery is variable; dependent on patient co-morbidities and tendon quality at repair.

Triceps Rupture Review References

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