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. 2014 Sep 18;3(5):e621-6.
doi: 10.1016/j.eats.2014.06.019. eCollection 2014 Oct.

Distal triceps knotless anatomic footprint repair: a new technique

James M Paci  1 , Jonathan Clark  1 , Angelo Rizzi  1
Affiliations

Distal triceps knotless anatomic footprint repair: a new technique

James M Paci et al. Arthrosc Tech. .

Abstract

Distal triceps rupture is a rare injury causing significant disability. Several techniques for treating distal triceps ruptures have been described using bone tunnels or suture anchors. More recent techniques have focused on re-creating the anatomic footprint of the distal triceps tendon. However, the increasing numbers of anchors used increase the risk to the articular surface, and all earlier techniques require knot tying and bulky knots beneath the thin posterior elbow soft-tissue envelope. We describe a technique combining the use of bone tunnels and a single suture anchor to create a knotless anatomic footprint repair of the distal triceps. By using this technique, we are able to create a tension-band construct that self-reinforces the anatomic repair and is very low profile while significantly decreasing risk to the articular surface.

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Figures

Fig 1
Fig 1
Transosseous cruciate repair. One should note the uncovered portion of the triceps anatomic footprint.
Fig 2
Fig 2
Tendon preparation for knotless anatomic footprint repair. (A) Krackow sutures are placed along the medial and lateral borders of the tendon, exiting just proximal to the footprint anterior to the tendon. (B) FiberLink sutures are passed medially and laterally proximal to the footprint. One should note that the loop ends are kept posterior to the triceps.
Fig 3
Fig 3
(A, B) Olecranon preparation for knotless anatomic footprint repair; parallel 2-mm tunnels are drilled in the olecranon. (C) A pilot hole for the 4.75-mm Biocomposite SwiveLock anchor is drilled between the distal bone tunnel exits.
Fig 4
Fig 4
Suture passage for knotless anatomic footprint repair. (A) Two tails of the lateral Krackow suture and the lateral FiberLink tail are passed through the lateral tunnel, and 2 medial suture tails and the FiberLink tail are passed through the medial tunnel. (B) The lateral FiberLink is used to shuttle 1 medial and 1 lateral suture down the lateral tunnel in a proximal-to-distal manner, with the process repeated to shuttle 1 medial and 1 lateral suture through the medial tunnel, to create (C) a box-and-x configuration of suture over the tendon footprint to evenly compress tendon to bone.
Fig 5
Fig 5
Final fixation for knotless anatomic footprint repair. (A) All 4 suture strands are loaded into the SwiveLock anchor and tensioned individually. (B) The anchor is inserted into the pilot hole. (C) Final construct.
See this image and copyright information in PMC

References

    1. Anzel S.H., Covey K.W., Weiner A.D., Lipscomb P.R. Disruption of muscles and tendons; an analysis of 1,014 cases. Surgery. 1959;45:406–414. - PubMed
    1. Penhallow D. Report of a case of ruptured triceps due to direct violence. N Y J Med. 1910;91:76–77.
    1. Sherman O.H., Snyder S.J., Fox J.M. Triceps tendon avulsion in a professional body builder. A case report. Am J Sports Med. 1984;12:328–329. - PubMed
    1. Lambert M.I. St Clair Gibson A, Noakes TD. Rupture of the triceps tendon associated with steroid injections. Am J Sports Med. 1995;23:778. - PubMed
    1. Tsourvakas S., Gouvalas K., Gimtsas C., Tsianas N., Founta P., Ameridis N. Bilateral and simultaneous rupture of the triceps tendons in chronic renal failure and secondary hyperparathyroidism. Arch Orthop Trauma Surg. 2004;124:278–280. - PubMed