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

Managing rerupture of the triceps brachii tendon after surgical repair is challenging due to poor tissue quality, retraction, and adhesions. This clinical scenario often requires augmentation with native tissue or tendon allografts. Traditional techniques include V-Y advancement, reinforced triceps advancement with double row or suture bridge fixation, and allograft tendon augmentation. This paper presents a novel method of fixation using an Achilles tendon allograft with a calcaneal bone block which aims to enhance previously described techniques. This new technique involves inserting an Achilles allograft calcaneal bone plug into the dorsal ulna to increase surface area for primary bone healing. The bone plug is then secured under a precontoured locking plate, potentially reducing the risks of displacement or fixation failure. This also avoids the placement of screws through the calcaneal plug, which puts it at risk for fracture. This technique also has drawbacks, such as increased costs, the potential need for a second surgery to remove hardware, and more extensive soft tissue dissection. In the patient case described, this method effectively reconstructed the triceps tendon in a revision setting.