Avulsion of the distal triceps tendon with fracture of the radial head

  • Ali H. ChamseddineEmail author
  • Roger M. Jawish
  • Hadi K. Zein
Case Report


We present a rare case of associated distal triceps tendon avulsion with radial head fracture; the lateral and medial collateral ligaments of the elbow were also ruptured. The patient underwent surgical procedure for the reinsertion of the triceps tendon using metallic anchors, radial head prosthetic replacement, and repair of the lateral collateral ligament. We believe this combined injury pattern of radial head fracture with triceps tendon rupture or avulsion should be considered according to the concept of the spectrum of elbow instability.


Triceps tendon rupture Triceps tendon avulsion Radial head fracture Radial head replacement Elbow instability 


Conflict of interest

No funds were received in support of this study. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.


  1. 1.
    Anzel SH, Covey KW, Weiner AD (1959) Disruption of muscles and tendons. An analysis of 1014 cases. Surgery 45:406–414PubMedGoogle Scholar
  2. 2.
    Hotchkiss RN (1997) Displaced fractures of the radial head: Internal fixation or excision. J Am Acad Orthop Surg 5:1–10PubMedGoogle Scholar
  3. 3.
    O’Driscoll SW, Jupiter JB, King GJ, Hotchkiss RN, Morrey BF (2000) The unstable elbow. J Bone Joint Surg Am 82:724–737CrossRefGoogle Scholar
  4. 4.
    Levy M, Fishel RE, Stern GM (1978) Triceps tendon avulsion with or without fracture of the radial head. A rare injury? J Trauma 18:677–679PubMedCrossRefGoogle Scholar
  5. 5.
    Levy M, Goldberg I, Meir I (1982) Fracture of the head of the radius with a tear or avulsion of the triceps tendon. A new syndrome? J Bone Joint Surg Br 64:70–72PubMedGoogle Scholar
  6. 6.
    Rahmi M, Arssi M, Hattoma N, Doumane B, Largab A, Trafeh M (2002) Traumatic avulsion of the triceps tendon with fracture dislocation of the elbow. A case report. Pan Arab J Orthop Trauma 6:25–27Google Scholar
  7. 7.
    Rood LK, Hevesy GZ (1991) An unusual complication of radial head fractures. Am J Emerg Med 9:553–554PubMedCrossRefGoogle Scholar
  8. 8.
    Shih-Wei L, Yu-Chung L (2007) Radial head fracture with neglected triceps tendon avulsion fracture: a case report. J Orthop Surg Taiwan 24:61–65Google Scholar
  9. 9.
    Tarsney FF (1972) Rupture and avulsion of the triceps. Clin Orthop 83:177–183PubMedCrossRefGoogle Scholar
  10. 10.
    Kupersmith LM, Hausman MR (2001) Fracture-dislocations of the elbow. Curr Opin Orthop 12:356–363CrossRefGoogle Scholar
  11. 11.
    O’Driscoll SW, Morrey BF, Korinek S, An KN (1992) Elbow subluxation and dislocation. A spectrum of instability. Clin Orthop 280:186–197PubMedGoogle Scholar
  12. 12.
    Ring D, Jupiter JB (1998) Fracture-dislocation of the elbow. J Bone Joint Surg Am 80:566–580PubMedCrossRefGoogle Scholar
  13. 13.
    Berthold M, Rikli DA (2002) Elbow dislocation with multidirectional instability; avulsion of the triceps tendon; and injury to the ulnar, median and radial nerves: case report. J Trauma 53:1176–1178PubMedCrossRefGoogle Scholar
  14. 14.
    Sai S, Fujii K, Chino H, Inoue J, Ishizaka J (2004) Old rupture of the triceps tendon with unique pathology: a case report. J Orthop Sci 9:654–656. doi: 10.1007/s00776-004-0820-5 PubMedCrossRefGoogle Scholar
  15. 15.
    Tatebe M, Horii E, Nakamura R (2007) Chronically ruptured triceps tendon with avulsion of the medial collateral ligament: a report of 2 cases. J Shoulder Elbow Surg 16(1):e5–e7. doi: 10.1016/j.jse.2005.12.010 PubMedCrossRefGoogle Scholar
  16. 16.
    Van Riet RP, Morrey BF, Ho E, O’Driscoll SW (2003) Surgical treatment of distal triceps ruptures. J Bone Joint Surg Am 85:1961–1967PubMedGoogle Scholar
  17. 17.
    Harris PC, Atkinson D, Moorehead JD (2004) Bilateral rupture of triceps tendon. Case report and quantitative assessment of recovery. Am J Sports Med 32:787–792. doi: 10.1177/0363546503258903 PubMedCrossRefGoogle Scholar
  18. 18.
    Fritz RC, Steinbach LS (1996) Magnetic resonance imaging of the musculoskeletal system. Part 3. The elbow. Clin Orthop 324:321–339PubMedCrossRefGoogle Scholar
  19. 19.
    Hotchkiss RN, Weiland AJ (1987) Valgus stability of the elbow. J Orthop Res 5:372–377PubMedCrossRefGoogle Scholar
  20. 20.
    Morrey BF, An KN (1983) Articular and ligamentous contributions to the stability of the elbow joint. Am J Sports Med 11:315–319PubMedCrossRefGoogle Scholar
  21. 21.
    Morrey BF (1997) Complex instability of the elbow. J Bone Joint Surg Am 79:460–469Google Scholar
  22. 22.
    Pina A, Garcia I, Sabater M (2002) Traumatic avulsion of the triceps brachii. J Orthop Trauma 16:273–276PubMedCrossRefGoogle Scholar
  23. 23.
    Yeh PC, Dodds SD, Smart LR, Mazzocca AD, Sethi PM (2010) Distal triceps rupture. J Am Acad Orthop Surg 18:31–40PubMedGoogle Scholar
  24. 24.
    Caputo AE, Mazzocca AD (2000) Radial head fractures. Tech Orthop 15:128–137CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Ali H. Chamseddine
    • 1
    • 2
    • 3
    Email author
  • Roger M. Jawish
    • 1
    • 3
  • Hadi K. Zein
    • 2
  1. 1.Faculty of MedicineLebanese UniversityBeirutLebanon
  2. 2.Department of Orthopaedic and Trauma Surgery, Sahel General HospitalUniversity Medical CentreBeirutLebanon
  3. 3.Sacré Cœur HospitalUniversity Medical CentreBeirutLebanon

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