Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA.
J Am Acad Orthop Surg. 2010 Jan;18(1):31-40. doi: 10.5435/00124635-201001000-00005.
Distal triceps rupture is an uncommon injury. It is most often associated with anabolic steroid use, weight lifting, and laceration. Other local and systemic risk factors include local steroid injection, olecranon bursitis, and hyperparathyroidism. Distal triceps rupture is usually caused by a fall on an outstretched hand or a direct blow. Eccentric loading of a contracting triceps has been implicated, particularly in professional athletes. Initial diagnosis may be difficult because a palpable defect is not always present. Pain and swelling may limit the ability to evaluate strength and elbow range of motion. Although plain radiographs are helpful in ruling out other elbow pathology, MRI is used to confirm the diagnosis, classify the injury, and guide management. Incomplete tears with active elbow extension against resistance are managed nonsurgically. Surgical repair is indicated in active persons with complete tears and for incomplete tears with concomitant loss of strength. Good to excellent results have been reported with surgical repair, and very good results have been achieved even for chronic tears.
肱三头肌远侧部撕裂较为少见。它通常与合成代谢类固醇的使用、举重和撕裂伤有关。其他局部和全身的危险因素包括局部类固醇注射、鹰嘴滑囊炎和甲状旁腺功能亢进症。肱三头肌远侧部撕裂通常由手伸直摔倒或直接打击引起。收缩的肱三头肌的离心负荷已被牵连,特别是在职业运动员中。最初的诊断可能很困难,因为触诊不一定能发现缺陷。疼痛和肿胀可能会限制评估力量和肘部活动范围的能力。尽管平片有助于排除其他肘部病变,但 MRI 用于确认诊断、分类损伤并指导治疗。对抗阻力主动伸直肘部的不完全撕裂采用非手术治疗。对于完全撕裂和伴有力量丧失的不完全撕裂,手术修复是指征。手术修复的报道结果良好至优秀,甚至对慢性撕裂也取得了非常好的结果。