title: Distal triceps tendon repair using Krakow whipstitches, K wires, tension band and double drilling technique: a case report.
abstract: BACKGROUND
  The management of distal triceps tears must address each patient's medical and functional status: in general, the literature has described satisfactory nonsurgical treatment in tears less than 50%. Tears greater than 50% are treated nonsurgically in a sedentary person and surgically in active patients. Complete tears are generally managed surgically: most reported repair techniques describe the use of Bunnell or Krakow whipstitch techniques, passing the sutures through transosseous drill holes in the ulna. Other described techniques include the use of suture anchors and direct tendon repair to a periosteal flap raised from the olecranon.
  
  
  METHODS
  In the presented report we describe the surgical technique used to treat a complete traumatic distal triceps tendon rupture associated with olecranon fracture in a 40-year-old Caucasian man with underlying poor tendon quality and postoperative assessment. To the best of our knowledge no studies describing the performed surgical technique, utilizing Krakow whipstitches, olecranon fixation with K wires and Zuggurtung tension band through transosseous drill holes have been previously described in the literature. At 30 days postoperatively the patient had regained full elbow flexion/extension and pronation/supination.
  
  
  CONCLUSIONS
  The described methodology, using a double ulnar tunnel to obtain fixation of the fragment, associated with a whipstitch locking-type suture for the triceps tendon, allowed proper fixation of the fracture and optimal reinsertion of the detached tendon on its footprint with sufficient strength.
authors.affiliation: Department of Orthopaedics and Traumatology, University Hospital Policlinico di Modena, Via del Pozzo 71, 41124, Modena, Italy. tarallo.luigi@policlinico.mo.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Tarallo
authors.affiliation: Department of Orthopaedics and Traumatology, University Hospital Policlinico di Modena, Via del Pozzo 71, 41124, Modena, Italy. francesco.zambianchi@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Zambianchi
authors.affiliation: Department of Orthopaedics and Traumatology, University Hospital Policlinico di Modena, Via del Pozzo 71, 41124, Modena, Italy. raffaele.mugnai@gmail.com.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Mugnai
authors.affiliation: Department of Orthopaedics and Traumatology, University Hospital Policlinico di Modena, Via del Pozzo 71, 41124, Modena, Italy. ccostanzini@alice.it.
authors.forename: Carlo Alberto
authors.initials: CA
authors.lastname: Costanzini
authors.affiliation: Department of Orthopaedics and Traumatology, University Hospital Policlinico di Modena, Via del Pozzo 71, 41124, Modena, Italy. catani.fabio@policlinico.mo.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Catani
mesh_terms: D001864:Bone Wires; D004551:Elbow Joint / Q000601:surgery; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D056740:Olecranon Process / Q000000981:diagnostic imaging / Q000293:injuries*; D011859:Radiography; D012421:Rupture; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*