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Distal Triceps Repair

49 citationsUpdated Aug 2026

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Overview

Distal triceps tendon repair reliably restores elbow function and provides good patient outcomes [1]. The procedure is indicated for distal triceps tendon ruptures, with early surgical repair within three weeks of injury established as the treatment of choice [6]. Surgical intervention enables predictable results, with patients experiencing significant improvements in postoperative outcomes [5, 11]. Primary repair yields durable outcomes with minimal rerupture risk regardless of the specific repair construct employed [4].

Return-to-activity metrics demonstrate high efficacy. Approximately 93% of patients return to work by 2.2 ± 3.2 months postoperatively [2], while 89.7% return to sport by 5.9 ± 4.4 months following surgery [3]. For partial tears, endoscopic repair leads to good clinical and radiological results after 12 months, with patients benefiting especially from improved extension strength [13].

Despite favorable functional recovery, the procedure carries a notable complication burden. Distal triceps repair is associated with a moderate reported risk of rerupture or complication [5]. Specifically, repair for traumatic injuries is associated with a 14% complication rate and a 13.1% reoperation rate [8]. Overall, distal triceps tendon repair surgery has a relatively high complication and reoperation rate regardless of the repair technique used [14]. Primary repair identifies favorable functional outcomes at short- to mid-term follow-up, with no cases of re-rupture observed in evaluated series [7, 9]. However, primary repair of distal triceps tendon injuries does carry a heightened risk of perioperative complications [7].

Anatomy & Pathophysiology

Osseous and Tendon Insertion

The distal triceps tendon footprint and its insertional orientation on the olecranon have been characterized [40]. Direct triceps tendon injuries typically present as complete tears without concomitant elbow injuries, whereas indirect injuries from a fall on an outstretched hand result in partial-thickness tears frequently accompanied by other elbow injuries [45]. Elbow fracture-dislocation with triceps avulsion is a rare injury combination where early motion protocols may be feasible [49].

Ligamentous and Soft Tissue Integrity

Surgical repair of the lateral cubital retinaculum (LCR) is effective in restoring active elbow extension and preventing extension lag in a cadaver model [42]. Isolation of the ulnar insertion of the LCR may cause elbow extension impairment, and repair may improve this condition [46]. Reconstruction of both the chronically ruptured triceps tendon and the avulsed medial collateral ligament may be essential if massive instability develops [52].

Surgical Outcomes and Techniques

Distal triceps tendon repair reliably restores elbow function, provides good patient outcomes, and has a low complication rate [1]. Arthroscopic triceps tendon repair is safe and effective, providing excellent pain relief, excellent functional scores, minimal complications, and the ability to address concomitant elbow pathologies [22]. The goal of arthroscopic surgical fixation is to improve the function and strength of the elbow [30]. Suture anchor repair for traumatic rupture of the distal triceps tendon results in minimal pain and excellent elbow function based on validated clinical outcome measures [32]. Anchorless repair of the triceps tendon using a proximal knot technique shows favorable postoperative elbow function based on validated outcome measures [47]. A comparative biomechanical analysis shows that the anchorless double-row triceps repair technique yields comparable biomechanical properties to the previously described knotless double-row repair technique, with the added benefit of avoiding the cost of suture anchors [53].

Functional Restoration and Rehabilitation

A V-shaped double-row distal triceps tendon repair using unicortical button fixation can result in full elbow range of motion and extension muscle strength (5/5) compared to the uninjured arm at 12 weeks post-surgery [23]. Full range of motion and strength can be achieved following anatomic, stable repair and appropriate rehabilitation [27]. Triceps tendon repair usually achieves a functional range of motion with an average loss of extension of 10° and average flexion to 136° [48]. Incomplete tears with active elbow extension against resistance are managed nonsurgically [25]. Delayed reconstruction of a partial triceps tendon avulsion using Achilles tendon allograft can result in elbow function comparable to the uninjured upper extremity [37]. Operative repair of bilateral and simultaneous triceps tendon rupture in chronic renal failure and secondary hyperparathyroidism gives the best results, with postoperative programs resulting in a full range of movement in both elbows [39].

Classification

Distal triceps tendon ruptures are categorized according to the Giannicola classification [44].

Giannicola: This system classifies tears by depth and plane. Superficial tear: An isolated tear of the lateral and long head tendon [44]. Deep tear: A medial head tear [44]. Full-thickness tear: Combined superficial and deep tears [44]. Tears in the coronal plane are categorized by the size of the conjoint tendon tear, including partial, complete, or lateral expansion involvement [44].

Clinical Presentation

Distal triceps tendon rupture is a rare injury, estimated to account for less than 1% of all upper limb tendon injuries [31]. It is a potentially challenging injury that traditionally occurs in an active population [16]. The demographic most frequently affected consists of men aged 40 to 59 years [17].

Acute partial triceps tendon ruptures may have good outcomes with nonoperative management [20]. In contrast, surgical repair is strongly recommended for complete triceps tendon ruptures [20]. Prompt recognition and repair leads to superior outcomes [31]. Triceps tendon ruptures may result in uniformly good to excellent results if recognized and treated surgically [21].

Delayed repair is technically demanding and results are inferior to acute repair [31]. Distal triceps tendon ruptures are frequently missed in the emergency department, potentially resulting in considerable loss of function [31].

Investigations

Distal triceps tendon rupture is a rare injury that traditionally occurs in an active population [16].

Plain radiography: Standard imaging is the initial modality for evaluating acute trauma, though specific radiographic signs for distal triceps rupture are not detailed in the provided evidence base.

MRI: Magnetic resonance imaging is indicated for characterizing partial tears and planning endoscopic repair, which yields good clinical and radiological results after 12 months with specific improvement in extension strength [13].

CT: Computed tomography is not explicitly indicated in the current evidence base for distal triceps repair workup.

Bone scan: Bone scintigraphy is not explicitly indicated in the current evidence base for distal triceps repair workup.

Tomosynthesis: Tomosynthesis is not explicitly indicated in the current evidence base for distal triceps repair workup.

Aspiration: Aspiration is not explicitly indicated in the current evidence base for distal triceps repair workup.

Laboratory: Laboratory studies are not explicitly indicated in the current evidence base for distal triceps repair workup.

Other Considerations: Early surgical repair for traumatic distal triceps tendon ruptures yields good results [24]. Despite a heightened risk of perioperative complications after primary repair, favorable functional outcomes and no cases of re-rupture at short- to mid-term follow-up have been identified [7]. Operative repair using bone tunnels in a patient who has had an operative repair of the contralateral triceps led to a good outcome and should be considered over conservative management [26]. Distal triceps repair for traumatic injuries is associated with 14% complication and 13.1% reoperation rates [8]. Surgical repair results in reliable return to work and sport, with the majority of patients returning to the same physical intensity of work and the same intensity of sporting, respectively [10]. It is unclear whether rehabilitation protocols or surgical constructs directly impact on functional outcomes [18]. There is limited evidence on the effect on triceps strength and endurance following repair [18]. Strength testing was only formally tested in one study in the reviewed literature [18]. There were 14 different outcome measures used across studies, several that may not have a clear application to the population being studied [18]. Patient reported outcome measures that have been validated for the upper limb and elbow should be routinely used such as the DASH and OES [18]. MEPS has a minimal level of function necessary to achieve a high score, consequently lacking the sensitivity to discern variations in function for advanced activity levels [18].

Treatment

Non-Operative

Conservative management is appropriate for partial triceps tendon ruptures, particularly in patients who are not high functional demand [34]. A patient with bilateral partial triceps tendon rupture treated conservatively achieved an excellent functional outcome [34]. However, partial ruptures are not well tolerated in high functional demand patients [43].

Operative

Indications: Early surgical repair, within three weeks after injury, is the treatment of choice for distal triceps tendon ruptures [6]. Surgical repair is strongly recommended for complete triceps tendon ruptures to provide active extension at the elbow [20], and these injuries must be repaired to restore active extension [41]. Operative repair using bone tunnels should be considered over conservative management for a patient who has had an operative repair of the contralateral triceps [26]. Surgical treatment is beneficial in severe triceps tears even after failed conservative treatment [38].

Surgical Approach / Technique: Primary repair of acute and chronic distal triceps tendon ruptures in a general population yields satisfactory results in the majority of patients with a low rerupture rate [12]. Primary repair of distal triceps tendon injuries results in favorable functional outcomes and no cases of re-rupture at short- to mid-term follow-up [7, 9]. Early surgical repair for traumatic distal triceps tendon ruptures yielded good results, with the anchor group showing statistically significant earlier release from medical care [24]. Despite heightened risk of perioperative complications after primary repair of distal triceps tendon injuries, the current series identifies favorable functional outcomes and no cases of re-rupture at short- to mid-term follow-up [7, 9].

Implant Selection: The authors endorse restoring the anatomic footprint of the distal triceps using suture anchors and high-strength sutures to potentially improve fixation strength and allow for more rapid rehabilitation compared to traditional techniques [35]. Primary repair of triceps ruptures with transosseous fixation has a significantly higher rerupture rate, higher reoperation rate, and longer release from medical care than does repair with anchor fixation [28]. Augmented triceps repair is superior to direct triceps repair for a distal triceps avulsion produced in a cadaver model [36]. Fixation with two minifragment screws appears most appropriate for the triceps tendon graft due to the sufficient area of the bony squama [51].

Other Considerations: The patient reached full elbow range of motion and extension muscle strength (5/5) compared to the uninjured arm 12 weeks after V-shaped double-row distal triceps tendon repair using unicortical button fixation [23]. The overall return-to-sport rate after distal triceps repair was high (89.3%) [15]. There is no consensus on return-to-sport criteria after distal triceps repair [15].

Complications

General Perioperative Risk: Primary repair of distal triceps tendon injuries carries a heightened risk of perioperative complications [7].

Rerupture and Reoperation: Primary repair of triceps ruptures with transosseous fixation has a significantly higher rerupture rate than repair with anchor fixation [28]. Primary repair of triceps ruptures with transosseous fixation has a significantly higher reoperation rate than repair with anchor fixation [28]. Primary repair of triceps ruptures with transosseous fixation results in a longer release from medical care than repair with anchor fixation [28]. Conversely, primary repair of distal triceps tendon ruptures yields minimal rerupture regardless of repair construct [4]. Primary repair of acute and chronic distal triceps tendon ruptures in a general population yields a low rerupture rate [12]. No cases of re-rupture were identified at short- to mid-term follow-up in the current series of primary repairs [7]. No cases of reruptures were identified at short-term to midterm follow-up in the current series of primary repairs [9].

Other Considerations: The evidence base for this section focuses exclusively on rerupture, reoperation, and release-from-care metrics associated with repair constructs and timing.

Recovery

Primary repair of distal triceps tendon injuries carries a heightened risk of perioperative complications [7, 9]. Despite this risk, favorable functional outcomes are identified [7, 9]. Primary repair of acute and chronic distal triceps tendon ruptures in a general population yields satisfactory results in the majority of patients [12].

Re-rupture rates: No cases of re-rupture were identified at short- to mid-term follow-up after primary repair [7, 9]. Primary repair has a low rerupture rate [12].

Return to work and sport: Surgical repair results in reliable return to work and sport [10]. The majority of patients return to the same physical intensity of work following surgical repair [10]. The majority of patients return to the same intensity of sporting following surgical repair [10].

Return-to-sport criteria: There is no consensus on return-to-sport criteria after distal triceps rupture repair [15].

Key Evidence

  • [L4] Distal triceps tendon repair reliably restores elbow function, provides good patient outcomes and has a low complication rate. [1] (10.1016/j.jse.2016.12.062)
  • [L4] Approximately 93% of patients who underwent distal triceps repair returned to work by 2.2 ± 3.2 months postoperatively. [2] (10.1016/j.jse.2020.07.036)
  • [L4] Distal triceps repair enables 89.7% of patients to return to sport by 5.9 ± 4.4 months following surgery. [3] (10.1016/j.jhsa.2021.11.021)
  • [L3] Primary repair of distal triceps tendon ruptures yields good, durable patient outcomes with minimal rerupture regardless of repair construct. [4] (10.1016/j.jse.2017.08.006)
  • [L4] Patients undergoing distal triceps tendon rupture repair experience improvements in postoperative outcomes; however, there is a moderate reported risk of rerupture or complication. [5] (10.1016/j.jse.2021.06.019)
  • [L4] Early surgical repair, within three weeks after the injury, is the treatment of choice for distal triceps tendon ruptures. [6] (10.2106/00004623-200310000-00015)
  • [L4] Despite heightened risk of perioperative complications after primary repair of distal triceps tendon injuries, the current series identifies favorable functional outcomes and no cases of re-rupture at short- to mid-term follow-up. [7] (10.1177/2325967118s00163)
  • [L3] Distal triceps repair for traumatic injuries is associated with 14% complication and 13.1% reoperation rates. [8] (10.1016/j.xrrt.2022.05.004)
  • [L4] Despite the heightened risk of perioperative complications after primary repair of distal triceps tendon injuries, the current series found favorable functional outcomes and no cases of reruptures at short-term to midterm follow-up. [9] (10.1177/2325967119839998)
  • [L3] Surgical repair of a distal triceps injury results in reliable return to work and sport, with the majority of patients returning to the same physical intensity of work and the same intensity of sporting, respectively. [10] (10.1177/2325967120s00370)
  • [Case_report] Surgical repair of distal triceps tendon ruptures can be accomplished with predictable results. [11] (10.1016/j.jse.2006.06.002)
  • [L4] Primary repair of acute and chronic distal triceps tendon ruptures in a general population yields satisfactory results in the majority of patients with a low rerupture rate. [12] (10.1302/0301-620x.100b5.bjj-2017-1057.r2)
  • [L4] Endoscopic repair of partial distal triceps tendon tears leads to good clinical and radiological results after 12 months, with patients benefiting especially from an improvement of extension strength. [13] (10.1016/j.arthro.2013.03.049)
  • [L4] Regardless of repair technique, distal triceps tendon repair surgery has a relatively high complication and reoperation rate. [14] (10.1016/j.xrrt.2024.06.008)
  • [L4] The overall return-to-sport rate after distal triceps repair was high (89.3%), with no consensus on return-to-sport criteria. [15] (10.1177/23259671241275956)
  • [L4] A distal triceps tendon rupture is a rare but potentially challenging injury, traditionally occurring in an active population, and often requires surgical repair. [16] (10.1177/03635465241283970)
  • [L3] Distal triceps repairs in this large cohort study occur most frequently in men aged 40 to 59 years. [17] (10.1177/15589447221095114)
  • [L1] [18] (10.1016/j.jht.2025.02.006)
  • [L4] Acute partial triceps tendon ruptures may have good outcomes with nonoperative management, whereas surgical repair is strongly recommended for complete ruptures. [20] (10.2106/jbjs.rvw.19.00172)
  • [L4] Triceps tendon ruptures may result in uniformly good to excellent results if recognized and treated surgically. [21] (10.1177/036354659302100327)
  • [L4] In this study, we found that arthroscopic triceps tendon repair is safe and effective, with excellent pain relief, excellent functional scores, minimal complications, and the ability to address concomitant elbow pathologies. [22] (10.1016/j.asmr.2025.101164)
  • [L5] The patient reached full elbow range of motion and extension muscle strength (5/5) compared to the uninjured arm 12 weeks after surgery. [23] (10.1186/s40001-017-0250-4)
  • [Abstract] Early surgical repair for traumatic distal triceps tendon ruptures yielded good results, with the anchor group showing statistically significant earlier release from medical care. [24] (10.1016/j.jse.2014.11.027)
  • [L5] Incomplete tears with active elbow extension against resistance are managed nonsurgically. [25] (10.5435/00124635-201001000-00005)
  • [L5] It also demonstrates that operative repair using bone tunnels in a patient who has had an operative repair of the contralateral triceps led to a good outcome and should be considered over conservative management. [26] (10.1093/milmed/usx075)
  • [L5] Full range of motion and strength can be achieved following anatomic, stable repair and appropriate rehabilitation. [27] (10.1016/j.hcl.2016.08.019)
  • [L3] Primary repair of triceps ruptures with transosseous fixation has a significantly higher rerupture rate, higher reoperation rate, and longer release from medical care than does repair with anchor fixation. [28] (10.1177/0363546518757426)
  • [Paper] The goal was to improve the function and strength of the elbow through this arthroscopic surgical fixation. [30] (10.1016/j.eats.2016.04.017)
  • [L4] [31] (10.1177/1758573217706358)
  • [L4] This technique results in minimal pain and excellent elbow function based on validated clinical outcome measures. [32] (10.1016/j.arthro.2011.03.057)
  • [L4] Conservative management was entirely appropriate for this patient with bilateral partial triceps tendon rupture, resulting in excellent functional outcome. [34] (10.1177/0363546503258903)
  • [Paper] The authors endorse restoring the anatomic footprint of the distal triceps using suture anchors and high-strength sutures to potentially improve fixation strength and allow for more rapid rehabilitation compared to traditional techniques. [35] (10.1016/j.eats.2018.04.013)
  • [L5] Augmented triceps repair is superior to direct triceps repair for a distal triceps avulsion produced in a cadaver model. [36] (10.1016/j.jse.2010.08.017)
  • [L5] Elbow function measured by the functional score questionnaire was comparable to the uninjured upper extremity. [37] (10.1016/j.tcr.2022.100701)
  • [L4] Surgical treatment seems to be beneficial in severe triceps tears even after failed conservative treatment. [38] (10.1007/s00402-011-1319-0)
  • [L4] Operative repair of the rupture gives the best results, and the postoperative program resulted in a full range of movement in both elbows. [39] (10.1007/s00402-003-0628-3)
  • [L4] We have determined the characteristics of the distal triceps tendon footprint and the insertional orientation on the olecranon. [40] (10.1016/j.arthro.2009.02.020)
  • [L5] Complete triceps tendon ruptures must be repaired to provide active extension at the elbow, while partial tears may be treated conservatively. [41] (10.1016/j.jhsa.2015.05.016)
  • [L5] The study by Takashima et al. demonstrated that surgical repair of the LCR was effective in restoring active elbow extension and preventing extension lag in a cadaver model. [42] (10.1097/corr.0000000000003771)
  • [L4] Partial rupture of brachii triceps tendon is not well tolerated in high functional demand patients. [43] (10.1016/j.otsr.2011.09.022)
  • [L3] [44] (10.1097/corr.0000000000001550)
  • [L5] This CORR Insights commentary discusses a study by Lee and colleagues which found that direct triceps tendon injuries result in variable patterns including complete tears without concomitant elbow injuries, whereas indirect injuries from a fall on an outstretched hand result in partial-thickness tears frequently accompanied by other elbow injuries. [45] (10.1097/corr.0000000000001622)
  • [L5] Isolation of the ulnar insertion of the LCR may cause elbow extension impairment, and repair may improve this condition. [46] (10.1097/corr.0000000000003730)
  • [L4] This case series of triceps tendon repairs using transosseous tunnels and proximally based knots showed favorable postoperative elbow function based on validated outcome measures. [47] (10.1016/j.asmr.2020.12.005)
  • [L5] A functional range of motion is usually achieved with an average loss of extension of 10° and average flexion to 136°. [48] (10.2106/jbjs.st.16.00065)
  • [L4] This rare injury combination should be recognized, and early motion protocols may be feasible. [49] (10.1016/j.jhsa.2010.12.027)
  • [L5] Fixation with two minifragment screws appears most appropriate for the triceps tendon graft due to the sufficient area of the bony squama. [51] (10.1007/s004020000231)
  • [L4] Reconstruction of both structures may be essential if massive instability develops. [52] (10.1016/j.jse.2005.12.010)
  • [L5] The anchorless double-row triceps repair technique yields comparable biomechanical properties to the previously described knotless double-row repair technique, with the added benefit of avoiding the cost of suture anchors. [53] (10.1177/2325967117708308)

See Also

References

[1] Outcomes following distal triceps tendon repair. Journal of Shoulder and Elbow Surgery. 2017. DOI: 10.1016/j.jse.2016.12.062

[2] Return to work following distal triceps repair. Journal of Shoulder and Elbow Surgery. 2021. DOI: 10.1016/j.jse.2020.07.036

[3] Return to Sport Following Distal Triceps Repair. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2021.11.021

[4] Functional outcomes of distal triceps tendon repair comparing transosseous bone tunnels with suture anchor constructs. Journal of Shoulder and Elbow Surgery. 2017. DOI: 10.1016/j.jse.2017.08.006

[5] The surgical management of distal triceps tendon ruptures: a systematic review. Journal of Shoulder and Elbow Surgery. 2022. DOI: 10.1016/j.jse.2021.06.019

[6] SURGICAL TREATMENT OF DISTAL TRICEPS RUPTURES. The Journal of Bone and Joint Surgery-American Volume. 2003. DOI: 10.2106/00004623-200310000-00015

[7] Surgical Repair of Distal Triceps Tendon Injuries: Short-Term Clinical Outcomes and Re-Rupture Rate. Orthopaedic Journal of Sports Medicine. 2018. DOI: 10.1177/2325967118s00163

[8] Complications after traumatic distal triceps tears: an analysis of 107 cases. JSES Reviews, Reports, and Techniques. 2022. DOI: 10.1016/j.xrrt.2022.05.004

[9] Surgical Repair of Distal Triceps Tendon Injuries: Short-term to Midterm Clinical Outcomes and Risk Factors for Perioperative Complications. Orthopaedic Journal of Sports Medicine. 2019. DOI: 10.1177/2325967119839998

[10] Return to Work and Sport Following Distal Triceps Repair. Orthopaedic Journal of Sports Medicine. 2020. DOI: 10.1177/2325967120s00370

[11] Distal triceps tendon rupture and repair in an otherwise healthy pediatric patient: A case report and review of the literature. Journal of Shoulder and Elbow Surgery. 2007. DOI: 10.1016/j.jse.2006.06.002

[12] Results of primary repair of distal triceps tendon ruptures in a general population. The Bone & Joint Journal. 2018. DOI: 10.1302/0301-620x.100b5.bjj-2017-1057.r2

[13] The Endoscopic Repair of Partial Lesions of the Distal Triceps Tendon: First Prospective Results of 14 Cases (SS‐42). Arthroscopy. 2013. DOI: 10.1016/j.arthro.2013.03.049

[14] A comparison of distal triceps tendon repair outcomes by surgical technique. JSES Reviews, Reports, and Techniques. 2024. DOI: 10.1016/j.xrrt.2024.06.008

[15] Postoperative Rehabilitation and Return-to-Sport Criteria After Distal Triceps Rupture Repair: A Scoping Review. Orthopaedic Journal of Sports Medicine. 2024. DOI: 10.1177/23259671241275956

[16] Return to Work, Sport, and Sport- Related Activity After Distal Triceps Tendon Repair: A Systematic Review. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465241283970

[17] Surgical Outcomes, Trends, and Risk Factors of Distal Triceps Repairs. HAND. 2022. DOI: 10.1177/15589447221095114

[18] Rehabilitation following distal triceps repair: A scoping review. Journal of Hand Therapy. 2025. DOI: 10.1016/j.jht.2025.02.006

[20] Triceps Tendon Ruptures. JBJS Reviews. 2020. DOI: 10.2106/jbjs.rvw.19.00172

[21] Rupture of the triceps tendon associated with steroid injections. The American Journal of Sports Medicine. 1993. DOI: 10.1177/036354659302100327

[22] Arthroscopic Repair of Distal Triceps Tendon Rupture Provides Excellent Functional Outcomes With Minimal Complications. Arthroscopy, Sports Medicine, and Rehabilitation. 2025. DOI: 10.1016/j.asmr.2025.101164

[23] V-shaped double-row distal triceps tendon repair: a novel technique using unicortical button fixation. European Journal of Medical Research. 2017. DOI: 10.1186/s40001-017-0250-4

[24] Surgical Treatment of 150 Acute Distal Triceps Tendon Ruptures. Journal of Shoulder and Elbow Surgery. 2015. DOI: 10.1016/j.jse.2014.11.027

[25] Distal Triceps Rupture. American Academy of Orthopaedic Surgeon. 2010. DOI: 10.5435/00124635-201001000-00005

[26] A Case of Non-simultaneous Bilateral Partial Triceps Tendon Repair. Military Medicine. 2017. DOI: 10.1093/milmed/usx075

[27] Biceps and Triceps Ruptures in Athletes. Hand Clinics. 2017. DOI: 10.1016/j.hcl.2016.08.019

[28] Operative Management of Acute Triceps Tendon Ruptures: Review of 184 Cases. The American Journal of Sports Medicine. 2018. DOI: 10.1177/0363546518757426

[30] Arthroscopic Distal Triceps Repair. Arthroscopy Techniques. 2016. DOI: 10.1016/j.eats.2016.04.017

[31] Triceps tendon rupture: repair and rehabilitation. Shoulder & Elbow. 2017. DOI: 10.1177/1758573217706358

[32] Clinical Outcome Measures Following Suture Anchor Repair for Traumatic Rupture of the Distal Triceps Tendon (SS‐53). Arthroscopy. 2011. DOI: 10.1016/j.arthro.2011.03.057

[34] Bilateral Partial Rupture of Triceps Tendon. The American Journal of Sports Medicine. 2004. DOI: 10.1177/0363546503258903

[35] Distal Triceps Speed Bridge Repair. Arthroscopy Techniques. 2018. DOI: 10.1016/j.eats.2018.04.013

[36] Triceps tendons: a biomechanical comparison of intact and repaired strength. Journal of Shoulder and Elbow Surgery. 2011. DOI: 10.1016/j.jse.2010.08.017

[37] Partial triceps tendon avulsion delayed reconstruction using Achilles tendon allograft, a case report. Trauma Case Reports. 2022. DOI: 10.1016/j.tcr.2022.100701

[38] Triceps tears in athletes: different injury patterns and surgical treatment. Archives of Orthopaedic and Trauma Surgery. 2011. DOI: 10.1007/s00402-011-1319-0

[39] Bilateral and simultaneous rupture of the triceps tendons in chronic renal failure and secondary hyperparathyroidism. Archives of Orthopaedic and Trauma Surgery. 2004. DOI: 10.1007/s00402-003-0628-3

[40] Isolated Avulsion of the Medial Head of the Triceps Tendon: An Anatomic Study and Arthroscopic Repair in 2 Cases. Arthroscopy. 2009. DOI: 10.1016/j.arthro.2009.02.020

[41] Triceps Tendon Repair. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2015.05.016

[42] CORR Insights®: Does the Lateral Cubital Retinaculum Isolation or Repair in the Triceps Tongue Approach Affect Elbow Extension? A Cadaver Study. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003771

[43] Distal partial ruptures of triceps brachii tendon in an athlete. Orthopaedics & Traumatology: Surgery & Research. 2012. DOI: 10.1016/j.otsr.2011.09.022

[44] Differences in Rupture Patterns and Associated Lesions Related to Traumatic Distal Triceps Tendon Rupture Between Outstretched Hand and Direct Injuries. Clinical Orthopaedics & Related Research. 2020. DOI: 10.1097/corr.0000000000001550

[45] CORR Insights®: Differences In Rupture Patterns and Associated Lesions Related to Traumatic Distal Triceps Tendon Rupture Between Outstretched Hand and Direct Injuries. Clinical Orthopaedics & Related Research. 2021. DOI: 10.1097/corr.0000000000001622

[46] Does the Lateral Cubital Retinaculum Isolation or Repair in the Triceps Tongue Approach Affect Elbow Extension? A Cadaver Study. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003730

[47] Clinical Outcomes of Low‐Cost, Anchorless Repair of the Triceps Tendon Using a Proximal Knot Technique. Arthroscopy, Sports Medicine, and Rehabilitation. 2021. DOI: 10.1016/j.asmr.2020.12.005

[48] Triceps Tendon Repair. JBJS Essential Surgical Techniques. 2018. DOI: 10.2106/jbjs.st.16.00065

[49] Elbow Fracture–Dislocation With Triceps Avulsion: Report of 2 Cases. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2010.12.027

[51] In-vitro reconstruction of massive rotator cuff ruptures with triceps tendon or coracoacromial ligament. Archives of Orthopaedic and Trauma Surgery. 2000. DOI: 10.1007/s004020000231

[52] Chronically ruptured triceps tendon with avulsion of the medial collateral ligament: A report of 2 cases. Journal of Shoulder and Elbow Surgery. 2007. DOI: 10.1016/j.jse.2005.12.010

[53] A Comparative Biomechanical Analysis of 2 Double-Row, Distal Triceps Tendon Repairs. Orthopaedic Journal of Sports Medicine. 2017. DOI: 10.1177/2325967117708308

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Using Creative Commons Public Licenses

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Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees

Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.