Arumilli Buchi, Adeyemo Foley, Samarji Richard
Manchester Royal Infirmary Oxford Road, Manchester, M13 9WL UK.
J Med Case Rep. 2009 Sep 8;3:9031. doi: 10.4076/1752-1947-3-9031.
Quadriceps rupture is a disabling injury mostly seen in men over 40 years of age. Bilateral quadriceps rupture is a rare injury that is often secondary to predisposing medical conditions. Ultrasound is a cheap and reliable tool for diagnosis but is operator dependent. Thus, magnetic resonance imaging is the preferred method of investigation despite its cost and availability. Prompt diagnosis and early surgical repair are needed for an optimal end result.
We report the case of a healthy 54-year-old Caucasian male farmer who presented with bilateral simultaneous complete quadriceps rupture, which was managed surgically and he was followed up for three years. He was previously under our care for enthesopathy of the quadriceps on both sides. We believe that chronic enthesopathy of the superior pole of patella made his quadriceps susceptible to complete rupture on eccentric loading.
Only a few cases of bilateral simultaneous complete quadriceps rupture in patients with symptomatic enthesopathy have been previously reported. We stress the importance of warning patients of the risk of developing complete tendon rupture when they present with an enthesopathy around the knee.
股四头肌断裂是一种致残性损伤,多见于40岁以上男性。双侧股四头肌断裂是一种罕见损伤,常继发于易感疾病。超声是一种廉价且可靠的诊断工具,但依赖操作者。因此,尽管磁共振成像有成本和可及性问题,仍是首选的检查方法。为获得最佳最终结果,需要及时诊断和早期手术修复。
我们报告一例健康的54岁白种男性农民,双侧股四头肌同时发生完全断裂,接受了手术治疗并随访三年。他之前因双侧股四头肌附着点病接受我们的治疗。我们认为,髌骨上极的慢性附着点病使他的股四头肌在离心负荷时易发生完全断裂。
之前仅报道过少数有症状附着点病患者双侧同时发生完全股四头肌断裂的病例。我们强调,当患者出现膝关节周围附着点病时,告知其发生完全肌腱断裂风险的重要性。