TITLE:
Missed Diagnosis of Snapping Triceps Syndrome: An Overlooked Cause of Failed Ulnar Nerve Transposition
AUTHORS:
Daniel Farivar, Justin J. Koh, Eugene Y. Tsai
KEYWORDS:
Snapping Triceps, Ulnar Nerve, Cubital Tunnel Syndrome, Wake up Test
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.15 No.4,
April
29,
2025
ABSTRACT: Background: Snapping triceps syndrome (STS) is a challenging condition to diagnose as it is rare and can easily be mistaken for ulnar nerve subluxation. Aim: To present a case of STS that was initially missed, and to describe the special diagnostic approaches and surgical techniques used for treatment. Case: A 21-year-old male patient previously underwent subcutaneous ulnar nerve transposition for ulnar nerve subluxation at the elbow. Postoperatively, patient continued to have elbow, reproducible with active elbow extension, and was taken back to the operating room with a diagnosis of persistent ulnar nerve subluxation versus STS. Patient underwent revision subfascial ulnar nerve transposition but intraoperative wake-up test still demonstrated snapping, so lateral transfer of the medial triceps tendon was performed with subsequent symptom relief. Conclusion: Intraoperative examination with active range of motion may help prevent overlooking the subtle diagnosis of snapping triceps syndrome.