What tendon tear occurs due to hyperextension of the arm?

From the Guidelines

Hyperextension of the arm can lead to a triceps tendon tear, specifically affecting the distal triceps tendon at the elbow, as it is more likely to result in injury of the lateral and long heads of the distal triceps tendon with an intact medial head tendon, as found by Lee et al [@23@]. This injury occurs when the arm is forcefully straightened against resistance, causing the tendon to rupture from its attachment. According to the study by Lee et al [@23@], a fall on an outstretched hand is categorized as an indirect injury, whereas a direct blow to the triceps by an object is considered a direct injury. The triceps tendon is particularly vulnerable to this injury because it experiences significant tension when the arm is suddenly straightened while the triceps muscle is contracting. Some key points to consider in the assessment and management of triceps tendon tears include:

• The use of MRI in the assessment of triceps tears, as it has an improved sensitivity for the detection of partial tears of the triceps tendon, as noted by Nicolay et al [@24@].
• The importance of identifying the extent of the tear, as partial tears may be managed conservatively, while complete tears often require surgical repair, as suggested by the study by Schenkels et al [@26@].
• The need for prompt treatment, including rest, ice, compression, and elevation (RICE), as well as over-the-counter pain medications like ibuprofen or naproxen to manage pain and inflammation.
• The role of physical therapy in the rehabilitation of triceps tendon tears, which can help to regain strength and mobility, as noted by the study by Tiegs-Heiden et al [@27@].

From the Research

Tendon Tear due to Hyperextension of the Arm

• The tendon tear that occurs due to hyperextension of the arm is a distal biceps tendon rupture, which is a relatively rare injury 1, 2, 3.
• This type of injury commonly occurs in the dominant extremity of middle-aged men during an excessive eccentric tension as the arm is forced from a flexed position 1.
• The distal biceps tendon rupture typically occurs after an eccentric extension load is applied to the elbow, resulting in a sudden, sharp, and painful tearing sensation in the antecubital region 3.
• The injury can be diagnosed using physical examination, radiographic analysis, and the SECEC elbow score, as well as magnetic resonance imaging (MRI) or ultrasound to distinguish between partial and complete tears 1, 4, 3.

Characteristics of Distal Biceps Tendon Ruptures

• Distal biceps tendon ruptures can be complete or partial, with partial ruptures exhibiting features similar to complete disruptions, including acute antecubital pain, weakness of elbow flexion, and forearm supination 4.
• The treatment of distal biceps tendon ruptures depends on the severity of the injury, with surgical anatomical reinsertion of the tendon at the radial tuberosity being the standard treatment for complete tears and significant partial tears 5.
• Conservative treatment is mostly limited to mild partial tendon tears, the elderly, individuals with a very low level of physical activity, patients with evident contraindications to surgical treatment 5.