Challenging surgical management of a major triceps tendon avulsion in a 4.6 kg cat without external coaptation.

Abstract

Case summary: Major avulsion of the triceps tendon insertion was diagnosed in a 7-year-old domestic shorthair cat 3 weeks after developing sudden severe weightbearing lameness of the left thoracic limb. Diagnosis was confirmed with orthopaedic, radiographic and ultrasonographic examinations. The absence of adequate bone stock prevented the use of conventional techniques for tendon reinsertion. Instead, the tendon was reattached using an ultra-high molecular weight polyethylene (UHMWPE) ExtraTape prosthesis. It was stitched into the triceps tendon and superficial fascia, then passed through a bone tunnel drilled in the olecranon and secured with a preassembled cortical button. No external coaptation was used. Although the cat experienced temporary mild lameness, pain-free and satisfactory use of the left thoracic limb was observed 4 weeks postoperatively. By 12 weeks, the cat's gait had returned to normal, with no gap between the tendon and the olecranon. The cat resumed normal gait and range of motion 8 months postoperatively.

Relevance and novel information: Triceps tendon disruption is difficult to manage. Conventional repair techniques consist of suturing the tendon ends and prolonged immobilisation with an external fixator, which may cause postoperative complications. This option is particularly difficult to implement in cats, which represents a challenge in postoperative management. The successful outcome obtained here suggests that surgical repair using the ExtraTape prosthesis, without external coaptation, may be a viable alternative for similar cases.