Chronic Distal Triceps Rupture Repaired Using Acellular Dermal Allograft as an Interposition Graft

Rupture of the triceps is a rare event. If triceps rupture is not immediately recognized, chronic ruptures produce a therapeutic problem. The residual tendon is often retracted, atrophic and of poor quality, therefore it is not usually appropriate for primary repair due to the high levels of tension encountered. Previously, multiple autograft techniques have been reported; however, this often leaves the patient with an additional surgical site and additional morbidity. Therefore we present our operative technique using acellular dermal allograft (ADA) as an interposition graft for the management of chronic distal triceps rupture. A 37-year-old male, right hand dominant, security guard presented to our institution’s orthopedic outpatient clinic with a 12-year history of weakness and deformity to his left arm. Preoperative magnetic resonance imaging demonstrated rupture of the distal triceps tendon. We performed an operative repair using an ADA in an interpositional manner. Ten months postoperatively magnetic resonance imaging demonstrated an intact repair, and at 19 months postoperatively the patient’s Disability of the Arm, Shoulder Hand (DASH) score was 0.83 and his strength was 72.8% of the contralateral side. Accordingly, we believe that using an interpositional ADA in our reported technique is a good option to treat chronic distal triceps rupture.