From the Physical and Rehabilitation Medicine Department, Prof. Doutor Fernando Fonseca Hospital, Amadora, Portugal (DMP, BDM, IMR, SRA, CVV-C); and Department of Adults' Rehabilitation 1, Physical and Rehabilitation Medicine Centre, Alcoitão, Portugal (JAC).
Am J Phys Med Rehabil. 2019 May;98(5):e43-e46. doi: 10.1097/PHM.0000000000001052.
Quadriceps tendon rupture is a rare lesion, occurring most frequently in males older than 60 yrs after a fall or trauma and associated with systemic diseases and risk factors. Bilateral injury is even more uncommon and disabling. The authors report a case of spontaneous bilateral quadriceps tendon rupture, nonsimultaneous (8 days apart), in a healthy 54-yr-old black male mason, that may be work related. The patient was included in a 6-mo rehabilitation program after surgical repair. Pain control and gait reacquisition were particularly difficult. Following the customized and phased rehabilitation program, the patient achieved the 6-mo functional outcomes reported for unilateral rupture. The authors highlight the rehabilitation specificities and challenges of the bilateral lesion and discuss the pathophysiological role of prolonged periods of working in repetitive quadriceps overuse postures on quadriceps tendon rupture.
股四头肌腱断裂是一种罕见的损伤,最常发生在 60 岁以上的男性,在跌倒或创伤后,并与全身疾病和危险因素有关。双侧损伤更为罕见且更具致残性。作者报告了一例健康的 54 岁黑人男性石匠的双侧股四头肌腱自发性断裂,且非同时发生(相隔 8 天),可能与工作有关。患者在手术后接受了 6 个月的康复计划。疼痛控制和步态恢复特别困难。在接受定制的分阶段康复计划后,患者在 6 个月时达到了单侧断裂报告的功能结果。作者强调了双侧损伤的康复特殊性和挑战,并讨论了长时间处于重复性股四头肌过度使用姿势下工作对股四头肌腱断裂的病理生理作用。