The triceps muscle is extraordinarily injury free, but rupture of the common tendon can occur. This is the least common of all tendon ruptures. Rupture most frequently occurs in young males (mean age, 26 years) secondary to trauma. There is an equal distribution between dominant and nondominant extremities. The site of rupture is usually the tendon-osseus junction, resulting in a high percentage of avulsion fractures of the olecranon. Musculotendinous junction and muscle belly ruptures are rare. The injury usually occurs as a result of indirect trauma from a fall on the outstretched extremity. Ruptures from direct blows and spontaneous ruptures from systemic illness have been reported.
Symptoms of acute rupture include pain and soft tissue swelling at the posterior elbow. The ability to extend the elbow is lost. Examination often shows a palpable defect proximal to the olecranon, along with localized tenderness and swelling. Radiographs of the elbow must be obtained, since olecranon avulsion fractures are present in greater than 80 percent of cases.
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