Skip to content

Patients › Elbow

肱三头肌腱远端撕裂

PDF In-depth PDF

A rare tear of the triceps tendon at the back of the elbow — how to spot it, who is at risk, and why complete tears usually need early repair.

举重运动员在大重量卧推失败时，肘部后方出现疼痛。
远端肱三头肌腱断裂：肱三头肌腱从肘关节后方撕裂，通常发生在用力推举或跌倒时。 Kieran Hirpara 4.0

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

肱三头肌是上臂后侧的大肌肉。其肌腱附着于肘尖（鹰嘴），正是它使您能够伸直手臂。当该肌腱从骨骼上撕裂时，损伤通常发生在瞬间：常见于跌倒时手掌撑地，或突然失去支撑的重物举起或推举。

事发时，您可能会感到肘后部出现锐痛或“啪”的一声。随后，该区域会出现肿胀和瘀伤，肘后部触痛明显。最具提示性的体征是：当尝试对抗重力或阻力伸直手臂时出现无力感：推开门、从椅子上撑起或过头举物时，可能会感到无力或无法完成。有时，您（或您的医生）可以在肘尖上方的肌腱处摸到柔软的间隙或凹陷。如果肌腱仅部分撕裂，您可能仍保留一定的伸直力量，但仍会伴有疼痛和无力。

这是一种罕见的损伤（肱三头肌是人体所有肌腱中最少发生断裂的之一），这也是其在初次评估中容易被漏诊的部分原因。

实际发生了什么

肱三头肌腱已部分或完全从其附着于鹰嘴的位置撕脱。完全撕裂意味着肌肉不再牢固地连接于骨骼，因此其产生的力量无法再传递以伸直肘关节。部分撕裂则保留了一些纤维的附着，因此仍保留部分力量。

这些撕裂几乎总是发生在肌肉强烈收缩的同时肌腱承受负荷时：例如，在试图伸直或支撑手臂的瞬间，手臂被迫弯曲。某些因素会使肌腱更容易失效：这种情况在男性中更为常见，尤其是举重者；合成类固醇的使用会削弱肌腱，是公认的风险因素；肘部周围的类固醇注射、反复的肘部（鹰嘴）滑囊炎，以及某些疾病（如长期肾脏疾病）都可能使肌腱更加脆弱。偶尔，一小块骨片会随肌腱一起被撕脱，这实际上有助于医生在X光片上确认诊断。

我们能做什么

Kieran Hirpara 医生是 Mater Private Hospital Rockhampton 的上肢外科医生，负责领导我们针对该疾病的管理方案。患者通常由其全科医生（GP）转诊至我们的诊所；如果物理治疗师建议您就诊，您仍需获得全科医生的转诊，才有资格享受 Medicare 报销。我们首先进行门诊评估，包括病史采集、体格检查以及必要时进行的影像学检查，以确立诊断。

第一步是做出诊断。除了体格检查外，还会拍摄 X 光片以寻找特征性的骨片，并通常使用超声或 MRI 扫描来确认撕裂是部分性还是完全性，以及肌腱回缩的程度。

随后的治疗方案取决于肌腱撕裂的程度以及您对手臂功能的需求：

  • 小的部分性撕裂（小于肌腱约一半）在体力需求较低的人群中，通常无需手术即可管理：先在肘部微屈的状态下佩戴支具一段时间，随后逐步恢复活动并进行强化训练。
  • 完全性撕裂、导致无力的部分性撕裂，以及活跃或体力需求较高人群中的撕裂，通常最适合通过手术将肌腱重新附着于骨骼来治疗。手术方法包括通过小型骨隧道穿过高强度缝线，或使用特殊植入物将肌腱锚定回其附着点。在肌腱发生瘢痕化和缩短之前尽早修复，可获得最佳效果。

预期情况

如果撕裂的肱三头肌腱在适当的时间得到修复，效果通常非常好：大多数人能够恢复强壮且可靠的肘关节伸展功能，并重返工作和运动。手术后，肘关节会在数周内受到保护，随后逐渐进行活动，后期再引入强化训练，因此完全恢复重体力活动需要数月而非数周。您的医疗团队将指导康复节奏。

与任何手术一样，存在一些需要注意的风险。主要风险包括肌腱再次松脱（再撕裂），这正是早期保护和分阶段恢复负重至关重要的原因；此外，肘尖部位皮肤愈合不良也是一个问题，因为该处组织较薄。在肌肉重建过程中出现的僵硬和暂时性无力是康复过程中的正常现象。

何时就医

  • 跌倒或负重后，肘部后方出现突然的疼痛或弹响，随后出现肿胀和瘀斑。请尽早进行评估。
  • 在对抗重力或阻力时伸直肘部困难或无力，或者无法用该手臂从椅子上撑起身体。
  • 在肘尖正上方可触及的柔软凹陷或间隙。
  • 肘部后方持续存在疼痛和无力且未缓解，即使仍能伸直手臂；部分撕裂可能表现为这种情况。早期评估可提供更多的治疗选择并带来更好的疗效。

深入探讨

Advanced reading: the deeper science (optional)

本节内容超出了您做出自身治疗决策所需的深度。远端肱三头肌撕裂值得额外阅读，原因在本网站上较为罕见：该病症足够罕见，以至于证据基础较小，而了解其规模之小本身在权衡您所获信息时便具有实用价值。

证据薄弱，且被如实报告

关于手术管理的最大规模系统综述涵盖了 560 名患者 [1]。研究发现，接受修复手术的患者在结局方面有所改善，但存在 中等程度的再破裂或并发症报告风险，并且重要的是，由于破裂模式、手术方式和结局指标存在异质性，难以确定哪种技术更优 [1]。

作为对比，本网站上肩部和膝关节疾病的相关数据基于数万人的汇总人群。而在此处，整个文献仅涵盖数百名患者，且涉及多种损伤模式。这并不意味着这些治疗无效。这意味着，关于它们之间微小差异的自信陈述缺乏支持，无论您在何处遇到此类陈述，都应持怀疑态度。

修复手术所实现的效果已有充分记录

在核心问题上，证据更为一致。在318名患者中，超过90%的现役军人、运动员和普通劳动力在远端肱三头肌修复后[2]重返运动或各自的工作岗位。

该人群对结果解读具有重要意义。这些人的工作具有高强度的体力要求，其重返岗位的情况可客观验证而非仅凭自我报告，这使得该数据比从普通人群中得出的类似数字更具信息价值。

一项技术对比显示出差异

尽管总体结论认为无法区分不同技术，但有一项对比确实显示出差异。在56例患者中，患者报告结局在缝线锚钉修复和经骨隧道修复方面均表现良好，但缝线锚钉修复在等速肌力测试、并发症率和再撕裂率方面显示出显著更优的结果 [3]。

样本量较小，应将其视为一种信号而非定论，这正是较大规模综述针对该领域整体文献所强调的观点。

为何在此处及时诊断至关重要

肱三头肌是唯一能在抗阻状态下伸直肘关节的肌肉，因此完全断裂在功能上的意义远非部分撕裂可比。完全撕裂的最佳治疗方式是手术修复，尤其是在急性期进行 [4]。

该损伤有两个特点使其容易被漏诊。由于部分附着点得以保留，往往仍能保留一定的伸肘功能，因此手臂看起来并非完全丧失功能；此外，肘部后方的肿胀和瘀斑常被归因于跌倒本身。实际的检查方法是抗重力伸肘试验，无法在向下推力的作用下保持手臂伸直（而非仅仅感到酸痛），才是具有临床意义的体征。

参考文献

[1] Alnaji O, Erdogan S, Shanmugaraj A, AlQahtani S, Prada C, Leroux T, et al. The surgical management of distal triceps tendon ruptures: a systematic review. J Shoulder Elbow Surg. 2022;31(1):217-24. https://doi.org/10.1016/j.jse.2021.06.019

[2] Johns WL, Miltenberg BH, Baumann AN, Kermanshahi N, Muchintala RR, Cohen SB. Return to work, sport, and sport-related activity after distal triceps tendon repair: a systematic review. Am J Sports Med. 2025;53(9):2240-7. https://doi.org/10.1177/03635465241283970

[3] Tran DV, Yetter TR, Somerson JS. Surgical repair of distal triceps rupture: a systematic review of outcomes and complications. JSES Rev Rep Tech. 2022;2(3):332-9. https://doi.org/10.1016/j.xrrt.2022.04.001

[4] Walker CM, Noonan TJ. Distal triceps tendon injuries. Clin Sports Med. 2020;39(3):673-85. https://doi.org/10.1016/j.csm.2020.03.003

Reviewed by Dr Kieran Hirpara · 7 August 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Creative Commons BY-NC 4.0

CC Creative Commons licence
BY Attribution — you must credit the source
NC NonCommercial — not for commercial use

Attribution-NonCommercial 4.0 International

Creative Commons Corporation ("Creative Commons") is not a law firm and does not provide legal services or legal advice. Distribution of Creative Commons public licenses does not create a lawyer-client or other relationship. Creative Commons makes its licenses and related information available on an "as-is" basis. Creative Commons gives no warranties regarding its licenses, any material licensed under their terms and conditions, or any related information. Creative Commons disclaims all liability for damages resulting from their use to the fullest extent possible.

Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

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.