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双侧髌骨骨刺患者的无创伤性急性双侧股四头肌肌腱断裂。病例报告及文献综述。

Atraumatic acute bilateral quadriceps tendon rupture in a patient with bilateral patella spurs. A case report and review of literature.

作者信息

Pagliari Micaela, Menna Carlo Raimondo, Migliorini Andrea, Molinari Marco

机构信息

Department of Orthopedic Surgery, Ospedale di Fiemme, CAVALESE (Trento).

出版信息

Acta Biomed. 2018 Dec 19;90(1-S):203-208. doi: 10.23750/abm.v90i1-S.8008.

Abstract

the spontaneous and simultaneous rupture of both quadriceps tendons is uncommon and has rarely been reported in medical literature. The current case involves a 62-years old man with bilateral atraumatic complete quadriceps tendon rupture. Aim of this study is to provide a systematic review of this case and a literature review of similar cases. Methods: we reviewed and analyzed this patient's records. Initial x rays of both knees showed a bilateral patellar spur. Real time ultrasonography scan of both knees showed a complete tear of quadriceps. The repair has consisted on end to end Krackow sutures associated with bone suture to the proximal pole of the patella using patellar drill holes. We also researched the literature for bilateral simultaneous rupture of the quadriceps tendon. Results: The patient suffered only from seasonal asthma (receiving only inhaled corticosteroids) and he was overweight (BMI: 33,5), he did not do any type of sport, he was a biker. The patient was able to walk after 3 weeks with both knee cast. The patients had a 120° pain free range of motion in both knees 4 months after surgery. Conclusion: Simultaneous bilateral quadriceps tendon rupture is really very rare and these are generally reported as case presentation in the literature. This injury usually presents in middle aged people with a history of chronic illness. The general recommendation is to perform surgical intervention within 48-72 hours after injury.

摘要

双侧股四头肌肌腱同时自发性断裂较为罕见,医学文献中鲜有报道。本病例为一名62岁男性,双侧无创伤性股四头肌肌腱完全断裂。本研究旨在对该病例进行系统回顾,并对类似病例进行文献综述。方法:我们回顾并分析了该患者的病历。双膝初始X线片显示双侧髌骨骨刺。双膝实时超声扫描显示股四头肌完全撕裂。修复方法为采用Krackow缝合法进行端端缝合,并通过髌骨钻孔将骨缝线与髌骨近端极相连。我们还检索了关于双侧股四头肌肌腱同时断裂的文献。结果:该患者仅患有季节性哮喘(仅接受吸入性皮质类固醇治疗),体重超重(BMI:33.5),不进行任何类型的运动,是一名骑自行车的人。患者在双膝石膏固定3周后能够行走。术后4个月,患者双膝无痛活动范围达120°。结论:双侧股四头肌肌腱同时断裂确实非常罕见,文献中通常将其作为病例报告呈现。这种损伤通常发生在有慢性病史的中年人身上。一般建议在受伤后48 - 72小时内进行手术干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c97d/6503423/d6e14a31fddc/ACTA-90-203-g001.jpg

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