Diagnosis and treatment of traumatic distal triceps tendon rupture in an adolescent. Case report

Abstract

Introduction: Distal triceps tendon ruptures are rare and usually associated with trauma. They usually occur following an eccentric muscle contraction, affecting mainly the insertion of the tendon into the olecranon. Often, these injuries are diagnosed late, which can lead to severe consequences.

Case presentation: A 17-year-old male patient presented to the emergency department of a university hospital (quaternary care level) in Bogotá D.C. (Colombia) due to severe pain, edema, and limited extension and flexion of the left elbow after suffering a crush injury. After the initial evaluation and based on the findings of an elbow X-ray, he was diagnosed with elbow contusion and was treated on an outpatient basis with anti-inflammatory drugs and immobilization with a sling. One week later, a modified Thompson test, X-rays, computed tomography, and magnetic resonance imaging were performed, establishing the presence of traumatic triceps tendon rupture. Surgery was performed using the transosseous cross repair technique with bone tunnels. At the two-year follow-up, it was possible to confirm complete integrity of the tendon and normal triceps function.

Conclusion: This case demonstrates that, although distal triceps rupture is rare and often undiagnosed on initial evaluation in the emergency department, early diagnosis and timely treatment can yield excellent functional outcomes. It is essential to consider this injury as a differential diagnosis in patients with elbow trauma to prevent treatment delays and improve prognosis.