A 42-year-old man with a prior history of anabolic steroid use presented to his primary physician one day after falling on both elbows while playing football. On physical examination, he had mild tenderness and a palpable defect over the olecranons bilaterally. He had full strength on extension; however, he complained of weakness and pain in both arms.
Initially, three view radiographs of both elbows showed a 1-cm ossific fragment in the posterior soft tissue located approximately 4 cm proximal to the posterior aspect of the olecranon. The margins of the fractured fragments were not corticated and thus appeared to be acute. Soft-tissue swelling was also appreciated on the posterior aspect of both arms. These findings indicated bilateral enthesophyte fracture with proximal retraction, suggestive of bilateral partial or complete avulsion/tear of the triceps tendon (Fig. 1).
Subsequent fat-saturated proton-density-weighted MRI of the right (Fig. 2) and left (Fig. 3) elbow revealed bilateral full-thickness tears of the triceps tendons, with extensive edema within the myotendinous portions and surrounding hemorrhage.
The patient underwent bilateral open triceps tendon repair without complication 15 days after sustaining injury.