Hewins Benjamin, Sparavalo Sara, Wong Ivan
Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
J Clin Orthop Trauma. 2024 Oct 29;58:102789. doi: 10.1016/j.jcot.2024.102789. eCollection 2024 Nov.
Simultaneous bilateral quadriceps tears are rare with fewer than 150 cases reported in the literature and typically occur in male patients greater than 40 years of age. If left untreated or with delayed clinical intervention, these injuries often lead to chronic disability including pain and reduced ambulation. Typical treatments include surgical repair with considerable post-operative rehabilitation and a guarded prognosis. However, given the scarcity of these cases, a consensus on a standard course of treatment remains unclear and ultimately at the discretion of the clinician. A 67-year-old male presented 6-months after complete, retracted tears of bilateral quadriceps tendons after a fall onto both knees in flexion. Treatment included: immediate bilateral quadriceps tendon repairs, immobilization, physiotherapy, and the daily use of novel tri-compartment offloader knee braces providing knee-extension assist. To our knowledge, this is the first report of a full return to independent ambulation following a delayed diagnosis and surgical intervention of complete bilateral quadriceps tendon tears.
双侧股四头肌同时撕裂的情况较为罕见,文献报道的病例不足150例,且通常发生在40岁以上的男性患者中。如果不进行治疗或临床干预延迟,这些损伤往往会导致慢性残疾,包括疼痛和行走能力下降。典型的治疗方法包括手术修复,并伴有大量的术后康复治疗,且预后并不乐观。然而,鉴于此类病例较少,对于标准治疗方案尚未达成共识,最终仍由临床医生自行决定。一名67岁男性在双膝屈曲位摔倒后双侧股四头肌肌腱完全回缩撕裂6个月后前来就诊。治疗措施包括:立即进行双侧股四头肌肌腱修复、固定、物理治疗,以及每天使用新型三腔卸载式膝关节支具以辅助膝关节伸展。据我们所知,这是第一例关于双侧股四头肌肌腱完全撕裂延迟诊断和手术干预后完全恢复独立行走的报告。