If you have any questions regarding the progress of the patient, the physician should be contacted. Triceps tendon repair physical therapy protocol mcs1524610. Rehabilitation guidelines for distal biceps tendon repair. Specific changes in the program will be made by the physician as appropriate for the individual patient. Triceps tendon repair adam seidl, md board certified. Microsoft word postoperative protocol triceps tendon repair. In cases of complete rupture, surgical repair is recommended but no guidelines exist on the optimum reconstructive. Protect repair 0 to 2 weeks precautions o elbow immobilized in posterior splint at 60 elbow flexion for 1st 2 weeks o no active elbow extension 6 weeks rom o gradual activepassive rom of shoulder in all planes while in splint o wristhandfinger full arom in splint. Rehabilitation guidelines for distal bicep tendon repair the elbow is a complex system of three joints formed from three bones. Direct repair may be possible for selected chronic tears.
Triceps tendon repair procedure rehabilitation protocol phase 1. Avoid creating pain discomfort is okay but pain should not occur and persist 3 days in a row. An incision is made on the front of the knee, over the tendon. Of this group of 856, only 8 instances of triceps tendon injury were reported, and 4 of these were due to laceration. Afterwards, a knee immobilizer or hinged brace is often used to protect the repair. Hearon elbow protocols advanced orthopedic associates. Triceps tendon rupture was first reported in 1868 by partridge. Biceps tendon and triceps tendon injuries request pdf. Suite 224a blacksburg, va 24060 54055273 postoperative phase i 24 hours to 34 weeks goals fa br icati o nfcu s tmmm ilizati pli i nst ructi oinprom andptected arom i ncreased tendoexcursio ed ema co ntrl andsar ag ent independenceinhep precautions. A resting longarm night splint holding the elbow in 45 degrees of exion and wrist in neutral may.
If it does, rest the patient until pain level is clearly decreasing. Arthrex distal triceps repair using knotless swivelock. Tendon healing back to bone is a slow process that requires many weeks under tension free conditions the success of tendon repair depends on factors including tear size, tissue quality, tension on the repair the subscapularis repair comes under tension during external rotation and forward elevation past 90. Rehabilitation following distal triceps repair will progress more slowly over the first 6 weeks to protect the.
A triceps tendon repair is an open procedure done through an approximately 5 cm incision on the back of the arm directly above the elbow. Questions regarding the progress of any specific patient are encouraged, and should be. Rehabilitation guidelines distal bicep tendon repair. Triceps tendonitis diagnosis, treatment and exercise. Injury to the distal triceps is most often the result of an eccentric muscle contraction. Elbow immobilized in posterior splint at 60 elbow flexion for 1st 2 weeks. Progress to your normal diet if you are not nauseated wound care to avoid infection, keep surgical incisions clean and dry you may shower by placing a large. James paci, md, stony brook, ny demonstrates a new technique for distal triceps repair using a single, knotless swivelock anchor. Operative repair of triceps tendon ruptures and olecranon fractures involved repair the bone andor tendons that extend the elbow. The physician reserves the right to either advance or delay this protocol as deemed necessary. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair.
Triceps repair rehabilitation protocol dr christopher ahmad. Distal biceps tendon repair rehab protocol 1 rehabilitation guidelines distal bicep tendon repair note. Postoperative instructions triceps tendon repair diet begin with clear liquids and light foods jellos, soups, etc. This protocol was developed for patients who have had a primary repair of the. Additional restrictions or modifications will be listed in the last paragraph of the operative report and the therapy instructions. This subsection of our website contains rehabilitation programs or protocols designed for patients with elbow problems. Wrist and hand gripping exercises phase ii week 26. Indications for distal triceps repair include partial or complete tendon ruptures. Distal biceps tendon repair rehabilitation protocol the following protocol should be used as a guideline for rehabilitation progression, but may need to be altered pending the nature and extent of the surgical procedure, healing restraints or patient tolerance. Avoid all passive motion into df for 1st 6 weeks postop 3. Protocol e2 is intended for the nonoperative treatment of patients with tennis elbow lateral epicondylosis. An alternate repair technique is the use of whip stitches for the tendon that are passed through two small transosseous tunnels. The tendon ends are identified and then sewn together. Distal triceps tendon repair protocol northwestern medical center.
Distal biceps tendon protocol brigham and womens hospital. Distal biceps tendon repair protocol this rehabilitation protocol has been developed for the patient following a tenodesis reattachment of the long head of the biceps tendon surgery. Triceps tendon repair protocol this rehabilitation protocol has been developed for the patient following a tenodesis reattachment of the long head of the biceps tendon surgery. Triceps tendon ruptures andrea celli definition elbow extension against gravity or resistance may be difficult or impossible when the distal triceps tendon is ruptured or avulsed from the olecranon insertion. Triceps repair rehabilitation protocol maximum protection phase day 1 to week 8 weeks 02 brace. Distal bicep tendon repair accelerated rehabilitation protocol the intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course for a patient that has undergone a distal biceps tendon repair. After the procedure, the arm is placed in a cast or splint to protect the surgical site and allow it to heal. Triceps tendon repair procedure rehabilitation protocol. General guidelines patient will be in rigid splint in elbow extension for two weeks. Distal triceps tendon repair university orthopedics. Cole,md,mba range of motion immobilizer exercises phase i 06 weeks 03 weeks. Rehabilitation program for distal biceps repair phase i week 1. Distal triceps repair postoperative protocol day 014 keep splint clean, dry and in place until followup o may wear sling, in addition to splint, if more comfortable no lifting greater than 12 pounds o may do selfcare activities as well as light duty work such as typing and writing.
Specific changes in the program will be made by the physician as appropriate for an individual patient. Distal biceps tendon repair rehabilitation protocol michael b. Traumatic tears can occur at several different anatomic regions, but they are most commonly observed at the insertion of the tendon such as an olecranon avulsion. Mar 28, 2018 direct repair may be possible for selected chronic tears. Rehabilitation protocol triceps tendon repair phase i. This protocol provides you with general guidelines for the rehabilitation of the patient undergoing triceps tendon repair. It is not intended to be a substitute for ones clinical decision making. Usually, the repair is done as an outpatient or overnight stay. It is by no means intended to be a substitute for ones clinical decision making. Triceps tendon ruptures most commonly occur acutely when a patient falls on an outstretched hand with the elbow in some flexion and a forced load is applied to the contracting triceps. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making.
A resting longarm night splint holding the elbow in 90 degrees and wrist in neutral may be fashioned at the. Partial lesions are functionally well tolerated in patients. Flexor tendon repair therapy protocol sideline orthopedics. Achilles repair rehabilitation protocol key considerations. The first of these is overstretch of the repair by moving too far into extension following a flexor tendon repair or too far into flexion following an extensor tendon repair.
The goal of the rehabilitation is to gradually regain motion in the elbow joint and eventually regain strength. Patient will be fitted with a hinged, limited rom brace lrom preoperatively. Distal biceps tendon repair rehabilitation protocol michael. Microsoft word postoperativeprotocoltricepstendonrepair. Sep 18, 2014 distal triceps tendon ruptures are rare injuries. This rehabilitation protocol has been developed for the patient following a. Tendon reconstruction an overview sciencedirect topics. Once located, the end of the tendon is cleared of any damaged tissue so the tendon has a fresh edge. Patellar and quad tendon repair info boston sports medicine. You can prevent triceps tendonitis by warming up and stretching before exercise. Revision surgery or cases involving allograft procedures may undergo modifications to the below guideline. Patient fit with irom elbow brace, to be worn at all times except bathing. Distal triceps repair postop physical therapy protocols. Triceps tendon repair is performed with the following steps.
Triceps tendon repair rehab protocol dr russell lafrance. Complete ruptures of all three heads tendon insertion long, lateral, and medial heads generally require surgical treatment. This protocol was developed for patients who have had a primary repair of the distal triceps tendon. This can include repairing or replacing the triceps tendon and reattaching the tendon to the bone. Brace locked at 0 degrees for ambulation for 68 weeks with use of bilateral axillary crutches. Flexor tendon repair therapy protocol 1 of 5 bart eastwood d. This protocol provides you with general guidelines for the rehabilitation of patients following a distal biceps repair or reconstruction. First, the ruptured or torn tendon is located by the surgeon. Triceps tendon rupture is a rare injury, estimated to account for less than 1% of all upper limb tendon injuries. Distal bicep tendon repair rehabilitation protocol the intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course for a patient that has undergone a distal biceps tendon repair. Rehabilitation guidelines for distal bicep tendon repair. The intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation. The stump is debrided, and retraction of the tendon is evaluated.
Distal biceps tendon repair rehabilitation protocol. Click on your rehabilitation protocol to download a pdf file containing. At 23 weeks home estim unit if needed for quadriceps muscle reed. Treatment will follow the defined protocol below and be carried out by physical therapist, athletic trainer, occupational therapist andor physical therapy assistants. Repair is preferably performed within the first three weeks for the best outcomes. The sutures are then crossed over the tendon to create a suture bridging construct completed with knotless swivelock anchors. This protocol will vary in length and aggressiveness depending on factors such as.
Two things cause gapping or rupture of a repaired tendon. The other protocols in this section are intended as postoperative rehabilitation protocols. Systemic diseases such as diabetes mellitus, renal osteodystrophy, and secondary hyperparathyroidism may compromise the. Brace locked at 30 degrees as specified by physician for weeks 36 physical therapy starts week 4. Please follow the protocol along with the instructions listed on the patients referral. The precaution always exists regarding gapping or potential rupture of a tendon until 12 weeks after repair. Two crossed bone tunnels are drilled, and an anchor is placed centrally in the olecranon. Tricepstendonrepairrehabprotocol phase107dayspostop posteriorsplintelbow extended wristandhandgrippingexercises phaseii1weekthrough6weekspostop.