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Distal triceps ruptures are rare injuries due to the special anatomical features of the muscle and tendon–bone junction.
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This injury typically occurs at the tendon–bone junction due to an eccentric contraction of the muscle.
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The treatment is controversial, especially in partial ruptures; surgical repair is indicated for complete ruptures of the distal triceps tendon.
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Several repair techniques have been described for acute complete ruptures.
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Chronic ruptures often require reconstruction rather than direct repair.
Cite this article: Demirhan M, Ersen A. Distal triceps ruptures. EFORT Open Rev 2016;1:255-259. DOI: 10.1302/2058-5241.1.000038.
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Facioscapulohumeral muscular dystrophy (FSHD) is a common hereditary disorder which typically results in scapular winging due to wasting of the periscapular muscles affected by this condition.
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Scapulothoracic arthrodesis (STA) is the current surgical treatment for FSHD patients with severe winging and preserved deltoid muscle.
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There are several different techniques in the literature such as multifilament cables alone and cable or cerclage wires combined with single or multiple plates. We prefer cables without plates as it provides independent strong fixation points and strongly recommend utilization of autograft.
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The functional results of studies report that regardless of the technique used, shoulder elevation and thus quality of life is improved, as shown with outcome scores.
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There are several complications associated with STA. Pulmonary complications are common and usually resolve spontaneously. Meticulous surgical technique and effective postoperative analgesia may reduce the incidence. Scapular complications which are associated with the fixation may be encountered in the early or late period, which are related to the learning curve of the surgeon.
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In conclusion, STA is a reliable solution to a major problem in FSHD patients that helps them maintain their activities of daily living until a cure for the disease is found. A successful result is strongly dependent on patient selection, and a multidisciplinary team of neurologists, geneticists and orthopaedic surgeons is required to achieve good results.
