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Revision Triceps Reconstruction With Achilles Bone Block Allograft Augmentation: A Novel Inlay Technique.

Matthew B Weber¹, Glenn Lee¹, Ilvy Cotterell²

¹Department of Orthopaedics, Virginia Commonwealth University Health System.

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|January 6, 2025

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Rerupture of the triceps tendon is difficult to manage. A novel technique using an Achilles tendon allograft with a calcaneal bone block offers a new fixation method for revision surgery.

Area of Science:

Orthopedic Surgery
Musculoskeletal Research
Biomedical Engineering

Background:

Triceps tendon rerupture after surgical repair presents significant management challenges.
Poor tissue quality, retraction, and adhesions complicate revision surgeries.
Current augmentation techniques include native tissue or allograft use with various fixation methods.

Purpose of the Study:

To present a novel fixation technique for triceps tendon rerupture using an Achilles tendon allograft with a calcaneal bone block.
To enhance existing augmentation methods for complex triceps tendon revision cases.
To describe the surgical procedure and evaluate its efficacy in a clinical setting.

Main Methods:

Utilized an Achilles tendon allograft with a calcaneal bone block for triceps tendon reconstruction.

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Inserted the calcaneal bone plug into the dorsal ulna to promote bone healing.

Secured the bone plug using a precontoured locking plate, avoiding screw fixation through the plug.

Main Results:

The novel technique effectively reconstructed the triceps tendon in a revision setting.
Fixation with a locking plate potentially reduces risks of displacement and fixation failure.
Avoided screw placement through the calcaneal plug, mitigating fracture risk.

Conclusions:

This technique offers a promising approach for managing challenging triceps tendon reruptures.
The use of a calcaneal bone block and locking plate fixation enhances stability.
Potential drawbacks include increased costs and the need for extensive soft tissue dissection.