Avulsion of the triceps tendon.

Avulsion of the triceps tendon should be suspected in patients who have pain about the elbow following a deceleration stress to the upper extremity. In three cases, the avulsion occurred both with or without a concomitant blow to the posterior aspect of the arm. Examination revealed pain, swelling, and a palpable depression just proximal to the olecranon. Roentgenograms showed avulsed osseous material. In the evaluation and management of triceps avulsion, it was important to differentiate between complete and partial tears. Careful examination of active range of motion of the elbow was the most important factor in making this determination. An avulsion was considered partial only if normal elbow motion and extension against resistance were found on follow-up examination a few days postinjury. Nonoperative management was successful in one case of partial tear (Case 2). Surgical therapy was advisable for complete avulsions. Surgical repair was successful using heavy nonabsorbable suture through olecranon drill holes. Injuries of tendon avulsion and rupture are likely to become more common as the number of patients with chronic renal failure, on dialysis, increases. Tendo-osseous weakness and related musculoskeletal disorders in renal osteodystrophy patients are unsolved problems.