The aim of the study was to analyze the results of primary tendon
reinsertion in acute and chronic distal triceps tendon ruptures
(DTTRs) in the general population. A total of 28 patients were operated on for primary DTTR reinsertions,
including 21 male patients and seven female patients with a mean
age of 45 years (14 to 76). Of these patients, 23 sustained an acute
DTTR and five had a chronic injury. One patient had a non-simultaneous
bilateral DTTR. Seven patients had DTTR-associated ipsilateral fracture
or dislocation. Comorbidities were present in four patients. Surgical
treatment included transosseous and suture-anchors reinsertion in
22 and seven DTTRs, respectively. The clinical evaluation was performed
using Mayo Elbow Performance Score (MEPS), the modified American
Shoulder and Elbow Surgeons Score (m-ASES), the Quick Disabilities
of the Arm, Shoulder and Hand score (QuickDASH), and the Medical
Research Council (MRC) Scale.Aims
Patients and Methods
Non-union of the radius and/or ulna is comparatively common in the treatment of forearm fractures. Bone graft from the iliac crest secured by rigid plate fixation under compression is indicated in non-unions with a bone defect longer than 2 cm. The aim of the study is to compare the results with the current literature. Thirteen patients (female: 1; males: 12), mean age 44 years (23–75 years), were treated in our department between 1993 and 2003. In 10 patients the original injury involved both radius and ulna; in the remaining three only the ulna was affected. All the fractures had been internally fixed, except for a radius fracture. Non-unions involved the ulna in eight cases, the radius in one case and both radius and ulna in four cases. A cortico-cancellous graft was used to fill a defect of the ulna in 11 cases and of the radius in two cases. In the non-unions of both bones only one bone was operated (one radius and three ulna); a different treatment was performed in the other bone. The mean time between the original injury and the indexed procedure was 7 months (3–14 months). The mean bone defect was 4 cm (2–6 cm). A T-shaped cortico-cancellous graft was always used. All the patients were evaluated clinically and radiographically with a mean follow-up of 4 years (1–10 years). Bony union was achieved in all the patients at an average time of 4 months (3–6 months). At the follow-up the mean elbow flexion was 130°, the mean extension lag 4°, the mean pronation 71° and the mean supination 61°. The mean grip strength was 38 kg, 81% of the contralateral side. Cortico-cancellous bone graft from the iliac crest is an effective technique to fill a bone defect of between 2 and 6 cm. Up to this length the mechanical properties of the graft are optimal for a rigid plate fixation under compression; moreover, biological conditions allow ready integration of the graft. Rigid fixation with cortico-cancellous bone graft from the iliac crest is a useful technique for forearm non-unions with a bone defect of between 2 and 6 cm.
