Nontraumatic Triceps Tendon Rupture in a Young Bodybuilder Athlete: A Case Report and Review of the Literature of a Known Injury in an Unknown Setting

INTRODUCTION: Triceps’ tendon rupture is thought to be a relatively rare injury, and its exact incidence is unknown. As a result of the rareness of this injury, very few cases of weightlifters or bodybuilders taking androgenic anabolic steroids have been published in the literature to date. In this article, we report a very rare case of non-traumatic triceps tendon rupture in a professional bodybuilder under androgenic anabolic steroids. CASE REPORT: A 32-year-old male patient was admitted to our emergency department, reporting that while trying to maneuver his motorbike to avoid collision with another vehicle, he felt sudden pain at the posterior elbow and heard a popping sound. Active extension of the elbow was found to be reduced, raising suspicion of triceps tendon rupture. Ultrasound and magnetic resonance imaging revealed rupture of the triceps, confirming the clinical diagnosis. Intraoperatively, an almost complete rupture of the triceps was noted at its insertion into the olecranon. After the recognition and preparation of the triceps’ footprint, two 3.5 mm titanium bone sutured anchors were placed at the anatomical insertion of the tendon, and the tendon was repaired using a modified double-row technique. Follow-up at 6 months and 1 year postoperatively revealed perfect Mayo Elbow Performance and Oxford Elbow Scores with no residual pain or range of motion deficits; triceps strength had returned to pre-injury levels. CONCLUSION: Triceps tendon rupture is thought to be a relatively rare injury and among the rarest tendon injuries. It usually occurs in patients with systematic diseases, such as renal disease, or on medication, such as androgenic anabolic steroid use. As a result of its rareness, very few cases of weightlifters or bodybuilders taking steroids have been reported in the literature. To our knowledge, this is the first case of non-traumatic triceps tendon rupture in a bodybuilder under oral androgenic anabolic steroids.