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The distal triceps tendon insertional anatomy-implications for surgery.

Raul Barco1, Pablo Sánchez2, Mark E Morrey3

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Detailed knowledge of the distal triceps insertion is crucial for elbow surgeries. This study identified distinct insertional areas, aiding diagnosis and surgical safety in the elbow.

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Area of Science:

  • Orthopedic Surgery
  • Anatomy

Background:

  • Increasing incidence of elbow procedures necessitates a better understanding of distal triceps anatomy.
  • Procedures like distal triceps repair and olecranon osteotomy require precise anatomical knowledge.

Purpose of the Study:

  • To investigate the morphology and dimensions of the distal triceps tendon and its insertion.
  • To define anatomical landmarks for surgical procedures in the distal triceps region.

Main Methods:

  • Dissection of five pair-matched upper limbs.
  • Detailed analysis of the triceps tendon, its olecranon insertion, and the triceps lateral retinaculum.
  • Identification of proximal muscle origins.

Main Results:

  • Three distinct insertional areas identified: posterior capsular (1.5 cm²), deep muscular (1.2 cm²), and superficial tendinous (2.8 cm²).
  • Triceps width at insertion averaged 2.6 cm; lateral retinaculum extended 2.5 cm.
  • The tendinous portion extended proximally 15.3 cm, with insertion 1.1 cm from the olecranon tip.

Conclusions:

  • Distinct triceps insertional heads offer insights for diagnosing and treating partial triceps tears.
  • A defined "safe zone" for capsulectomy and olecranon tip osteotomy enhances surgical safety.