Avulsions of Triceps Brachii : associated injuries and surgical treatment ; a case series.

This study reports the clinical presentations, intra -operative findings, type of the treatments, outcome of the treatment and specially associated injuries in patients with the avulsion of the distal end of the triceps brachii (TB) tendon. We studied 6 patients with rupture or avulsion of the distal end of the TB tendon. The medical records, imaging files, clinical outcomes at the final follow up visit were reviewed. The clinical outcomes were assessed by Mayo Elbow Score at the final follow-up visit. All patients were male, 4 of them having injury in the left hand as the non-dominant hand. Mean age of them was 34.5 years. All cases had small bony fleck in the posterior of elbow in lateral radiograph. Three patients had associated injuries -including intra-articular fractures and medial collateral ligament rupture. In one case V-Y plasty of the distal TB was done. In 4 patients the results of surgery were excellent, one was good and one was fair. Although TB tendon rupture is rare, it should be -considered in differential diagnosis of the upper -extremity trauma and its associated injuries should be addressed properly.

Size and shape of the lunate surface in different types of pincer impingement: theoretical implications for surgical therapy.

OBJECTIVE: Acetabular rim trimming is indicated in pincer hips with an oversized lunate surface but could result in a critically decreased size of the lunate surface in pincer hips with acetabular malorientation. There is a lack of detailed three-dimensional anatomy of lunate surface in pincer hips. Therefore, we questioned how does (1) size and (2) shape of the lunate surface differ among hips with different types of pincer impingement? METHOD: We retrospectively compared size and shape of the lunate surface between acetabular retroversion (48 hips), deep acetabulum (34 hips), protrusio acetabuli (seven hips), normal acetabuli (30 hips), and hip dysplasia (45 hips). Using magnetic resonance imaging (MRI) arthrography with radial slices we measured size in percentage of the femoral head coverage and shape using the outer (inner) center-edge angles and width of lunate surface. RESULTS: Hips with retroversion had a decreased size and deep hips had normal size of the lunate surface. Both had a normal shape of the outer acetabular rim. Protrusio hips had an increased size and a prominent outer acetabular rim. In all three types of pincer hips the acetabular fossa was increased. CONCLUSION: Size and shape of the lunate surface differs substantially among different types of pincer impingement. In contrast to hips with protrusio acetabuli, retroverted and deep hips do not have an increased size of the lunate surface. Acetabular rim trimming in retroverted and deep hips should be performed with caution. Based on our results, acetabular reorientation would theoretically be the treatment of choice in retroverted hips.