Case Overview

This video discusses the case presentation of a 24-year-old man with bilateral snapping triceps syndrome and concomitant cubital tunnel syndrome in whom nonsurgical treatment failed. Snapping triceps syndrome is a rare and underrecognized condition involving painful dislocation of the medial triceps and subluxation and irritation of the ulnar nerve. Failure to manage this condition may result in failed cubital tunnel decompression. This video demonstrates a step-by-step surgical approach for the management of snapping triceps syndrome. This approach is the preferred surgical technique of the authors of this video.

Surgical Technique

The surgical technique consists of ulnar nerve decompression and subfascial anterior transposition, followed by posterior transposition of the medial tendinous portion of the triceps to prevent continued medial dislocation with elbow flexion. Postoperatively, the patient is immobilized for 2 weeks, after which progressive range of motion and strengthening are initiated.

Results

We have performed this procedure in two patients without complications. The patients returned to full activities by 3 months postoperatively. In 2018, Rioux-Forker et al reported a similar outcome in one patient treated via an analogous surgical technique. In 1998, Spinner and Goldner reported excellent results in four patients treated via lateral transposition of the snapping medial triceps.

Summary

Snapping triceps syndrome is an underrecognized cause of medial elbow pain and ulnar neuritis. This video attempts to increase awareness of snapping triceps syndrome among hand and upper extremity surgeons and demonstrates our preferred surgical technique.