Who needs a triceps?

Vet Rec. 2018

Naomi Frances Earley 1 2, Gemma Ellse 1, Adrian M Wallace 3, Kevin J Parsons 4, Katja Voss 5, Lauren C Pugliese 6, Andy P Moores 7, Richard Whitelock 1 8, Christoph Stork 9, Sorrel J Langley-Hobbs 1 4, Heidi Radke 1

Background:
Triceps tendon disruption is a rare orthopedic injury in dogs and cats, which can occur as rupture or avulsion. Previously, only isolated case reports existed, often highlighting trauma or corticosteroid use as predisposing factors. This study aimed to describe a larger series of cases, focusing on etiology, treatment methods, complications, and long-term outcomes.

Methods:
This retrospective multicenter study included 13 cases (9 dogs, 4 cats) diagnosed with triceps tendon disruption between 2003 and 2014 across seven veterinary hospitals. Diagnosis was confirmed during surgery. Treatment involved surgical tendon repair with postoperative immobilization, and outcomes were assessed through veterinary follow-up and owner questionnaires. Complications were categorized as minor, major medical, or major surgical.

Results:
Trauma (5 cases), wounds or abscesses (4), prior orthopedic surgery (2), and corticosteroid therapy (1) were commonly associated with tendon disruption. Surgical repair utilized modified tendon suture patterns, mainly through bone tunnels in the olecranon. Immobilization was achieved with transarticular external skeletal fixation (TAESF) or spica splints. Complications occurred in 11 of 13 cases, mostly linked to immobilization methods, with pin tract infections and wound issues being common. One case experienced a traumatic rerupture two years postoperatively. Long-term follow-up showed 5 animals achieved normal function and 4 had acceptable function, despite the high complication rate.

Limitations:
The study's retrospective design and small sample size limit the ability to generalize findings or compare surgical and immobilization techniques. Follow-up durations varied, and three cases were lost to follow-up. Diagnostic imaging for chronic tendinopathy was inconsistently applied.

Conclusions:
Triceps tendon disruption in dogs and cats can be associated with prior trauma, corticosteroid use, wounds, or orthopedic interventions. While complications—particularly from immobilization—are frequent, most cases achieve normal or acceptable long-term function post-surgery. Awareness of potential complications and careful surgical technique are key to improving outcomes.

Mediolateral radiograph of the left elbow of a 10-year-old female neutered (FN) domestic shorthair (DSH) (case 2) with presumed acute triceps tendon disruption. This radiograph shows small mineralised opacities inthe region of triceps tendon insertion, soft tissue swelling and a roughened olecranon. The finding of mineralisation is more consistent with a chronic tendinopathy, rather than an acute disruption .FIG 2: A 7-year-old female neutered (FN) Staffordshire bull terrier (case 7)with a type 1a hinged transarticular external skeletal fixation (TAESF) applied to the lateral aspect of the left humerus and radius to span the elbow. Thec onnecting bar was removable to allow passive flexion and extension of the elbow.

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