Question about triceps tendon rupture at the elbow

[mtomaino]

I recently received this question and wanted to use it as a springboard for discussing the injury:

Hi Dr. Tomaino, I\'ve been diagnosed with a full left ruptured distal triceps tendon by an Ortho after he reviewed my MRI. The injury occurred on 4/4 and I\'m scheduled for surgery on 4/20. Is that soon enough, or could the scheduled date risk further complications/compromised outcome?

In short, complete tears are most optimally addressed surgically as soon as possible to optimize repair---meaning that the longer one waits, the more likely that muscle stiffness will prevent tension free repair. Though a delay ofseveral months with the rotator cuff, and up to 6 weeks with a biceps rupture at the elbow, may not interfere with repair and successful outcome, triceps repair is best performed within 3 weeks!

A paper by Van Reit et al in the Journal of Bone and Joint Surgery in 2003 made this point. All repairs fixed within the 3 week period were successful. If one delays, graft may be required, and a higher risk of failure exists. Unlike with the biceps tendon---which is not critical to functional elbow flexion, functional elbow extension requires a triceps.