PMC4719357_01
X-rays, MRI and intraoperative findings, a) preoperative lateral radiograph of the injured elbow showing the flake sign, a small cortical fracture avulsed from the olecranon (white arrow, box); b) magnetic resonance image, showing complete triceps rupture from the tendo-osseous junction with triceps retraction (2 cm) and oedema of the nearer soft tissues; c) and d) intraoperative pictures of the complete triceps tendon rupture and its repair to bone with not-absorbable wires
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F1
X-rays showed a small bony cortical avulsion of the posterior olecranon (Fig. 1a). Ultrasounds and Magnetic Resonance imaging both confirmed the complete triceps rupture at the tendo-osseousjunction (Fig. 1b). Surgical exploration revealed a complete rupture of the triceps tendon distal insertion, with avulsion of a small flack of cortical bone and partial conservation of lateral expansions to the forearm fascia (Fig. 1c). After surgical debridement triceps tendon was reinserted on the posterior aspect of the olecranon (Fig. 1d).
Histological analysis of intraoperatory specimens with typical features of overload-related chronic tendonopathy. a) hematoxilin and eosin staining, showing condroid degeneration with calcic precipitates (20x); b) Goldner's tricromie, showing dense collagen with reparative angioblastic tissue and haemorragic outflows (lOx); c) Azan Mallory staining, showing condromixoid degeneration with neo-formed vessels (20x); d) Van Gieson staining, showing angioblastic tissue and collagen dense bands (20x).
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F2
It reported fibrous connective tissue with sclerohyalinosis, chronic microtraumatism-attributable chondrocalcinosis-like degeneration, mixoid degeneration and chronic inflammation foci with neoangiogenesis (Fig. 2a-d).