Tricep Rupture

  • Injury to the triceps is rare and almost always occurs distally.
  • More common in young men, ruptures result from either a fall on an outstretched hand causing a forceful flexion of an extended elbow, or a direct blow to the olecranon.
  • Spontaneous ruptures from systemic illnesses, particularly hyperparathyroidism, have also been reported.
  • Triceps rupture usually causes pain in the posterior elbow.
  • Examination of the elbow reveals swelling and tenderness posteriorly just proximal to the olecranon.
  • A sulcus with a more proximal mass, representing the retracted triceps muscle, may be palpated.
  • With partial tears, some degree of function remains; however, with complete ruptures, the ability to extend the elbow is lost.
  • A modified Thompson test can be used to evaluate triceps function.
  • The upper extremity is positioned such that the arm is supported, and the forearm is hanging in a relaxed position with 90 degrees of flexion.
  • Squeezing the triceps muscle should produce extension of the forearm unless a complete rupture is present.
  • Radiographs are needed, as avulsion fractures of the olecranon are common.
  • US and MRI may aid in diagnosis, especially of partial tears.
  • ED treatment includes sling, ice, analgesics, and referral to an orthopedic surgeon for definitive care.
  • Complete ruptures require surgical repair, whereas most partial tears can be treated conservatively with immobilization.