Distal Triceps Tendon Rupture-First Retrospective Study in Central Europe

Background: This retrospective study is the only one in the last 10 years from central Europe and provides a current picture of prevalence, new diagnostic modalities, new methods of surgical treatment, and also offers new insights into post-operative care. Triceps tendon rupture is the least reported among all the tendon injuries in the literature. In general, effective treatments for tendon injuries are lacking because the understanding of tendon biology lags behind that of the other components of the musculoskeletal system. Tendon tissue has a low number of cells and growth hormones and thus a lack of natural healing ability. Understanding the links between the mechanical and biological parameters involved in tendon development, homeostasis, and repair is a prerequisite for the identification of effective treatments for chronic and acute tendon injuries. Methods: The authors statistically evaluated the set of patients with this diagnosis in the largest University Hospital in Slovakia over the last 10 years. Results: Between 2014 and 2023, 23 patients with distal triceps tendon ruptures (DTTR) were treated at University Hospital. In some years not a single patient with this diagnosis underwent surgery, reinforcing the idea that DTTR may be either rare or underdiagnosed. The incidence in our region is 0.46 cases per 100,000 inhabitants. The average age of patients was 57.7 years, with a male predominance of 90%. Less than half of the patients (43.5%) underwent surgical intervention, and the median time from injury to surgery was less than 10 days. This rapid timeline indicates a high standard of medical care, given the semi-elective nature of the surgery and the need for MRI (Magnetic Resonance Imaging) confirmation of tendon rupture exceeding 50% of the fibers before proceeding with surgery. The three standard surgical techniques were employed in approximately equal proportions. Conclusions: This study suggests that none of the methods is currently preferred, and that the choice of the technique was largely determined by perioperative findings and the surgeon's discretion. Post-operative complications were minimal, with only one patient experiencing any issues after surgery.