Basic Science
Insertional anatomy of the triceps brachii tendon

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Hypothesis

Triceps tendon anatomy is important for surgical approaches to the elbow and tendon repair. The purpose of this study is to describe both the qualitative and quantitative anatomy of the triceps brachii tendon insertion.

Materials and methods

Thirty-six elbows were dissected from twenty-three cadavers. Dimensions of the triceps tendon proper, lateral triceps expansion, and tendon insertion were measured. The central triceps tendon morphology was described.

Results

All specimens showed a distinct lateral tendon expansion continuous with the anconeus fascia (mean width, 16.8 mm). The mean width of the proper triceps tendon was 23.7 mm. The mean maximum olecranon width was 26.9 mm. The ratio of the triceps tendon width to the olecranon width averaged 0.88. The mean thickness of the central tendon insertion was 6.8 mm. The medial triceps tendon showed a distinct, rolled medial edge and an insertion consistently confluent with the central tendon. The triceps footprint insertion was dome shaped. The mean insertional width and length of the tendon proper were 20.9 mm and 13.4 mm, respectively. The mean distance from the olecranon tip to the tendon was 14.8 mm. The tendon width, thickness, and insertional dimensions correlated with the olecranon width.

Conclusions

The lateral triceps expansion is a consistent anatomic finding with a width that is approximately 70% of the width of the central tendon. The triceps insertion has a broad width and narrow thickness that expands distally and correlates with the size of the olecranon. Knowledge of this anatomy will help the surgeon optimize surgical approaches and triceps repair techniques.

Section snippets

Materials and methods

Thirty-six fresh-frozen cadaveric upper extremity specimens spanning from the disarticulated glenohumeral joint to the hand were obtained from the Department of Anatomy at our institution. None of the specimens had evidence of prior surgery or injury to the elbow. Specimens were excluded if there was evidence of osteoarthritis of the elbow manifested by osteophyte formation at the olecranon tip or fossa. The mean age of the cadavers was 71.3 years (range, 47-89 years). There were 13 male and 10

Results

Interobserver reliability was determined for each of the measured values in 14 specimens. Intraclass correlation coefficients ranged from 0.903 to 0.996, indicating excellent interobserver reliability (Table I).

Discussion

The anatomy of the distal triceps tendon insertion has received little attention in the orthopaedic literature. An accurate understanding of this anatomy is important for posterior elbow approaches where a split or reflection of the triceps mechanism is performed for deep exposure. Strategies to minimize surgical insult or post-repair complications to the triceps insertion must be founded in a better understanding of the normal anatomy.

On the medial aspect of the elbow, the triceps mechanism

Disclaimer

The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

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