Purpose
Triceps detachment and olecranon osteotomy are 2 techniques used to enhance exposure
in elbow surgery. Both the techniques can potentially add considerable morbidity and
lengthen the recovery after surgery. Triceps-sparing surgery can potentially mitigate
those issues. The purpose of this study was to evaluate the triceps tendon insertion
at a histologic level to help improve triceps-sparing surgical techniques used in
elbow trauma and arthroplasty.
Methods
Seventeen fresh-frozen cadaveric elbow specimens were collected. The olecranon and
its soft tissue attachments were isolated. We performed gross measurements and sectioned
the specimens for histologic evaluation in the saggital or coronal planes. The proximal-to-distal
and medial-to-lateral dimensions of the tendon and the distance from the proximal
tip of the olecranon to the proximal tendon insertion were measured microscopically
on stained embedded sections.
Results
The proximal-to-distal dimension of the triceps tendon insertion was less than previously
reported, whereas the medial-to-lateral dimension was similar. The true distance from
the tip of the olecranon to the proximal tendon insertion was greater than the previously
reported distance obtained via gross measurement.
Conclusions
Gross measurement of the triceps tendon insertion overestimates and inaccurately represents
the true insertional footprint. Gross measurement has been shown to demonstrate consistent
disparity compared with histologic measurement. Histologic investigation provides
a more accurate description.
Clinical relevance
The finding that the distance from the articular tip of the olecranon to the proximal
tendon insertion is greater than previously reported may have clinical implications.
A triceps split approach may allow more visualization and exposure of the posterior
joint and, therefore, lessen the need for triceps detachment or olecranon osteotomy.
Key words
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Article info
Publication history
Published online: June 17, 2021
Accepted:
May 3,
2021
Received:
April 28,
2020
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
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© 2022 by the American Society for Surgery of the Hand. All rights reserved.
