| Popis: |
Triceps injuries are relatively uncommon, but the character of the tendon attachment lends itself to arthroscopic repair. The diagnosis is made by a history of injury, pain, and weakness localized to the posterior elbow. On examination, the triceps stress test provides evidence of triceps injury. Radiographs may show triceps traction spurs, and MRI will clearly show the damaged tendon. Indications for surgery include pain and limitations of activity, while contraindications are active infection in the olecranon bursa or lack of surgical experience with arthroscopic techniques. The surgical technique of a double row repair requires the surgeon to be comfortable viewing and operating in both the elbow joint and the olecranon bursa. Protection of the ulnar nerve is essential and represents the major risk in performing the surgery. The olecranon attachment site is debrided and a double- or triple-loaded anchor inserted for the proximal row repair. The sutures are retrieved through the triceps proximal to the tear and the proximal tendon repaired. The arthroscope is switched to the bursal view, and the sutures are retrieved and a second row of the repair is completed. Postoperatively, the patient is placed in a posterior splint in near full extension followed by the use of a protective brace that allows a gradual return of motion. Physical therapy is initiated at 1 week but restricted to being performed in the protective brace for 6 weeks. Athletic sport conditioning is started and allowed to progress as tolerated, with a return to sport usually by 4 months. |
