Triceps Tendon Fascia for Collateral Ligament Reconstruction About the Elbow: A Clinical and Biomechanical Evaluation

In this article, we report on a cohort of patients who underwent elbow ligament reconstruction using triceps tendon fascia (TRI) and compare this alternative graft to a standard, the palmaris longus tendon (PL).

The biomechanical properties of 8 TRI grafts were compared with those of 8 PL grafts, and 10 patients with TRI elbow ligament reconstructions were retrospectively clinically evaluated.

Compared with PL, TRI had significantly more creep, but significantly less cross-sectional area and ultimate failure stress. Ultimate failure load and stiffness did not differ between grafts. Median (SD) postoperative Patient-Rated Elbow Evaluation score (0 = worst, 100 = best) was 79.3 (52). There was no statistical difference between preoperative and postoperative motion. All 10 patients had full triceps strength, and 9 of 10 elbows were stable on examination.

With different graft morphology taken into account, PL had a statistically smaller cross-sectional area and double the ultimate failure stress. When compared using the proportions that would be used during surgi­cal reconstruction, however, the grafts were comparable in ultimate failure strength and stiffness. It is unclear whether the statistically significant 0.8-mm difference in creep translates into clinical relevance. Clinically, patients reported good functional outcomes, motion, strength, and stability.