Tendon rupture after local steroid injection

Thirteen patients who developed 15 ruptured tendons subsequent to injection of a depository steroid in or about the tendons are described. Eight were treated surgically. Ruptures were encountered in three Achilles tendons, two supraspinati, one lateral epicondylar attachment at the elbow, eight tendons of the long head of the biceps at the shoulder, and one anterior tibial tendon. Measures designed to lessen this complication are described. In most cases triamcinolone hexacetonide was used as the depository steroid, mixed with procaine or lidocaine. Patients with this complication who were not treated surgically were the older patients who had ruptures of the tendon of the long head of the biceps.