Triceps tendon avulsion: a rare injury

Triceps tendon avulsion is one of the rare tendinous injuries. Such injuries can easily be missed, and should be kept as a differential diagnosis in all patients who present with pain and swelling at the back of the elbow after a traumatic event.

We present a case of triceps tendon avulsion which was missed in the initial workup by a local practitioner. Careful physical examination and evaluation of the X-rays clinched the diagnosis. The patient was treated surgically by transosseous suture technique using the Krakow method. The end result was a good range of movement and a power equal to the uninjured side. A high index of suspicion, physical examination seeking a palpable gap, and search for a 'flake' fracture on lateral radiographs will help make the diagnosis of triceps avulsion. Early recognition of these injuries and prompt intervention are the cornerstones of a successful outcome. A second examination after a few days, when the swelling has reduced, should be the standard in doubtful cases or during any unclear joint injury. We recommend a primary repair through a transosseous suture technique using Krakow method for optimal results.