{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:02:34Z","timestamp":1756425754024,"version":"3.44.0"},"reference-count":19,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,4,15]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>Triceps tendon (TT) rupture combined with medial collateral ligament (MCL) avulsion is rare and often diagnosed late. An early 30s alpinist presented with elbow pain, swelling and tenderness after a fall, resulting in a partial TT rupture and tear of the anterior band of the MCL, diagnosed through MRI. The surgical intervention involved distal triceps re-insertion and MCL repair.<\/jats:p>\n               <jats:p>Distal TT rupture and MCL lesions manifest with non-specific symptoms, representing a challenge, especially in an acute setting. Management for combined injuries remains controversial. In this case, the decision to acutely repair both was driven by the patient\u2019s high functional demand and the potential failure of conservative treatment. This approach was favoured for its simplicity, faster recovery and avoidance of complications associated with reconstruction surgery. This case report emphasises the importance of a careful assessment, underscoring the significance of early intervention over a sequela-focused approach.<\/jats:p>","DOI":"10.1136\/bcr-2025-265578","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T04:15:29Z","timestamp":1745554529000},"page":"e265578","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["When a fall leads to an unusual injury: rare combination of a partial triceps tendon rupture and a proximal avulsion of the medial collateral ligament"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9280-0093","authenticated-orcid":false,"given":"Joana","family":"Almeida","sequence":"first","affiliation":[{"name":"Orthopedics and Traumatology Department, Hospital CUF Porto, Porto, Portugal"},{"name":"Orthopaedics and Traumatology Department, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6770-7997","authenticated-orcid":false,"given":"Ana Isabel","family":"Morais","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department, Hospital CUF Porto, Porto, Portugal"},{"name":"Orthopaedics and Traumatology Department, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"given":"Maria Jo\u00e3o","family":"Almeida","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department, Hospital CUF Porto, Porto, Portugal"},{"name":"Orthopaedics and Traumatology Department, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"given":"Nuno","family":"Neves","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department, Hospital CUF Porto, Porto, Portugal"},{"name":"I3S Institute, Porto, Portugal"}]},{"given":"Carlos","family":"Maia Dias","sequence":"additional","affiliation":[{"name":"Hospital da Luz Torres de Lisboa, Lisbon, Portugal"}]},{"given":"Manuel","family":"Ribeiro Silva","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department, Hospital CUF Porto, Porto, Portugal"},{"name":"I3S Institute, Porto, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"2025082723413257000_18.4.e265578.1","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.2106\/00004623-200310000-00015","article-title":"Surgical treatment of distal triceps ruptures","volume":"85","author":"van Riet","year":"2003","journal-title":"J Bone Joint Surg Am"},{"key":"2025082723413257000_18.4.e265578.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2011.06.017"},{"key":"2025082723413257000_18.4.e265578.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2004.06.008"},{"key":"2025082723413257000_18.4.e265578.4","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1016\/j.jse.2005.12.010","article-title":"Chronically ruptured triceps tendon with avulsion of the medial collateral ligament: a report of 2 cases","volume":"16","author":"Tatebe","year":"2007","journal-title":"J Shoulder Elbow Surg"},{"key":"2025082723413257000_18.4.e265578.5","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s11751-009-0057-0","article-title":"Combined surgical treatment for missed rupture of triceps tendon associated with avulsion of the ulnar collateral ligament and flexor-pronator muscle mass","volume":"4","author":"Daglar","year":"2009","journal-title":"Strategies Trauma Limb Reconstr"},{"key":"2025082723413257000_18.4.e265578.6","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1055\/a-1865-0033","article-title":"Distal Triceps Rupture with an Injury of the Medial Ulnar Collateral Ligament: a Result of a Fall Onto an Outstretched Arm - a Case Series","volume":"162","author":"Ott","year":"2024","journal-title":"Z Orthop Unfall"},{"key":"2025082723413257000_18.4.e265578.7","first-page":"15","article-title":"Complete Rupture of the Triceps Tendon and Ulnar Collateral Ligament of the Elbow in a 13-Year-Old Football Player: A Case Report","volume":"8","author":"Khalil","year":"2018","journal-title":"J Orthop Case Rep"},{"key":"2025082723413257000_18.4.e265578.8","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/BTH.0000000000000168","article-title":"The Blocking Flap for Ulnar Nerve Instability After In Situ Release: Technique and a Grading System of Ulnar Nerve Instability to Guide Treatment","volume":"21","author":"Tang","year":"2017","journal-title":"Tech Hand Up Extrem Surg"},{"key":"2025082723413257000_18.4.e265578.9","doi-asserted-by":"crossref","first-page":"e621","DOI":"10.1016\/j.eats.2014.06.019","article-title":"Distal triceps knotless anatomic footprint repair: a new technique","volume":"3","author":"Paci","year":"2014","journal-title":"Arthrosc Tech"},{"key":"2025082723413257000_18.4.e265578.10","doi-asserted-by":"crossref","first-page":"31","DOI":"10.5435\/00124635-201001000-00005","article-title":"Distal triceps rupture","volume":"18","author":"Yeh","year":"2010","journal-title":"J Am Acad Orthop Surg"},{"key":"2025082723413257000_18.4.e265578.11","doi-asserted-by":"publisher","DOI":"10.1177\/230949900501300317"},{"key":"2025082723413257000_18.4.e265578.12","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1097\/CORR.0000000000001550","article-title":"Differences in Rupture Patterns and Associated Lesions Related to Traumatic Distal Triceps Tendon Rupture Between Outstretched Hand and Direct Injuries","volume":"479","author":"Lee","year":"2021","journal-title":"Clin Orthop Relat Res"},{"key":"2025082723413257000_18.4.e265578.13","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200204000-00010"},{"key":"2025082723413257000_18.4.e265578.14","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506288752"},{"key":"2025082723413257000_18.4.e265578.15","first-page":"BR290","article-title":"The triceps brachii muscle and its insertion on the olecranon","volume":"12","author":"Windisch","year":"2006","journal-title":"Med Sci Monit"},{"key":"2025082723413257000_18.4.e265578.16","doi-asserted-by":"crossref","first-page":"e549","DOI":"10.1016\/j.asmr.2023.02.007","article-title":"The Rate of Medial Ulnar Collateral Ligament Repair Is Increasing While Reconstruction Remains the Most Common Procedure Overall Among Early-Career Orthopaedic Surgeons","volume":"5","author":"Spivey","year":"2023","journal-title":"Arthrosc Sports Med Rehabil"},{"key":"2025082723413257000_18.4.e265578.17","doi-asserted-by":"crossref","DOI":"10.1177\/23259671231158373","article-title":"Medial Ulnar Collateral Ligament Repair With Augmentation: A Systematic Review and Meta-analysis of Preclinical Studies","volume":"11","author":"Boksh","year":"2023","journal-title":"Orthop J Sports Med"},{"key":"2025082723413257000_18.4.e265578.18","first-page":"35","article-title":"Triceps Tendon Rupture - A Novel Repair of an Uncommon Injury","volume":"10","author":"Homen","year":"2020","journal-title":"J Orthop Case Rep"},{"key":"2025082723413257000_18.4.e265578.19","doi-asserted-by":"crossref","first-page":"99","DOI":"10.2302\/kjm.57.99","article-title":"Primary ligament repair for elbow dislocation","volume":"57","author":"Jeon","year":"2008","journal-title":"Keio J Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-265578","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:41:39Z","timestamp":1756363299000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-265578"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":19,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,24]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bcr-2025-265578"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-265578","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}