Department of Emergency Medicine, University of Missouri–Kansas City/Truman Medical Center, Kansas City, MO 64018, USA.
Am J Emerg Med. 2012 Jan;30(1):261.e3-5. doi: 10.1016/j.ajem.2010.11.011. Epub 2010 Dec 24.
Simultaneous bilateral patellar tendon rupture occurs rarely and is even rarer in patients without systemic disease or predisposing conditions. We present a case of bilateral, midsubstance patellar tendon ruptures along with a partial anterior cruciate ligament tear from a fall from a standing height in an otherwise healthy adult without any predisposing conditions. Most patients that sustain a tendon rupture have risk factors for tendonopathy including chronic renal disease, systemic lupus erythematosus, rheumatoid arthritis, or exposure to medications (such as corticosteroids or fluoroquinolones). Currently, there are approximately 50 reported cases of bilateral patellar tendon rupture in the scientific literature; however, only a small minority occurred in patients without any predisposing factors. Most of the reports of a bilateral tendon rupture without systemic disease occurred in the inferior pole of the tendon, with only a few of these occurring in the midsubstance. Because of the rarity of this event in a patient without systemic disease, this condition is often misdiagnosed. Emergency physicians should maintain a high degree of suspicion in those patients with concerning clinical and/or radiographic findings.
双侧髌腱同时断裂较为罕见，在无系统性疾病或易患因素的患者中更为罕见。我们报告了一例在无任何易患因素的情况下，健康成年人从站立高度坠落导致双侧髌腱中部同时断裂，并伴有部分前交叉韧带撕裂的病例。大多数发生腱病的患者存在腱病的危险因素，包括慢性肾脏病、系统性红斑狼疮、类风湿关节炎或接触药物（如皮质类固醇或氟喹诺酮类药物）。目前，在科学文献中有大约 50 例双侧髌腱断裂的报道；然而，只有少数患者没有任何易患因素。大多数无系统性疾病的双侧腱断裂报告发生在腱的下极，只有少数发生在腱的中部。由于这种在无系统性疾病的患者中罕见的情况，这种疾病经常被误诊。急诊医生在那些具有可疑临床和/或影像学表现的患者中应保持高度警惕。
