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.