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Updated: Nov 4, 2025

Novel Triple-Loop Technique for Suturing TFCC Injuries without Transosseous Tunnel
Published on: May 23, 2025
[Transosseous reconstruction of triceps tendon rupture : Surgical technique]
Nael Hawi1, Sam Razaeian2, Christian Krettek2
1Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland. hawi.nael@mh-hannover.de.
Objective:
Transosseous reconstruction of the triceps tendon.
Indications:
All tears of the triceps tendon that allow a tension-free reconstruction.
Contraindications:
Retracted triceps tendon tears that do not allow a tension-free reconstruction after mobilization.
Surgical Technique:
Two nonabsorbable sutures are threaded through two crossing transosseous canals. In addition, an anchor is placed directly in the footprint. Using the first nonabsorbable suture the tendon is sutured using the Krackow technique and subsequently shuttled transosseously distally and knotted there with its other part. Using the first suture pair of the anchor the tendon is sutured in a similar manner and knotted within the tendon. With the second pair pressure to the avulsion fragment can be increased by knotting it distally to the first knot. Alternatively, sutures of the suture anchor can be used with a Mason-Allen technique.
Postoperative Management:
For the first 6 weeks a ROM brace is applied with gradual release of flexion. Free flexion after 6 weeks is allowed. Beginning of strengthening exercises after 12 weeks.
Results:
Authors have reported good results after surgical treatment of triceps tendon ruptures. Regardless of possible extension deficits described in the literature, in the case presented an excellent postoperative outcome with a free range of motion was achieved.
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