Mishra Baibhav, Raj Manish, Behera Sudarsan, Bhadani Janki Sharan, Kumar Rajeev, Kumar Pawan
Department of Orthopaedics, All India Institute of Medical Science, Deoghar, Jharkhand, India.
Department of Orthopaedics, Paras HMRI Hospital, Patna, Bihar, India.
J Orthop Case Rep. 2024 Dec;14(12):36-40. doi: 10.13107/jocr.2024.v14.i12.5010.
Quadriceps tendon rupture is a traumatic injury where the quadriceps detaches from the patella, disrupting the knee's extensor mechanism. Bilateral ruptures, first documented in 1949, are rare, with an incidence of 0.17-2.5% Diagnosis involves a clinical examination, revealing a palpable defect above the patella and inability to perform a straight leg raise. Risk factors include metabolic disorders, rheumatoid arthritis, connective tissue diseases, and steroid use. In younger patients, it often results from direct trauma. Magnetic resonance imaging is the preferred diagnostic tool. While partial tears may be managed non-operatively, surgical repair is typically required for complete disruption of the extensor mechanism.
A young man presented with an inability to walk for 1 month after a fall. He was diagnosed with bilateral quadriceps tendon rupture. Primary open repair was performed, followed by the application of bilateral long knee braces. The patient was advised delayed weight-bearing and initiated on quadriceps strengthening exercises.
After 12 months of follow-up, the patient showed significant improvement in function and range of motion compared to preoperative status. Primary open repair of bilateral quadriceps tendon ruptures proved to be an effective treatment, leading to satisfactory recovery and a return to good functional outcomes.
股四头肌肌腱断裂是一种创伤性损伤,即股四头肌从髌骨处分离,破坏膝关节的伸肌机制。双侧断裂最早于1949年有文献记载,较为罕见,发病率为0.17%-2.5%。诊断包括临床检查,可发现髌骨上方有可触及的缺损,且无法进行直腿抬高。危险因素包括代谢紊乱、类风湿性关节炎、结缔组织疾病和使用类固醇。在年轻患者中,通常由直接创伤引起。磁共振成像(MRI)是首选的诊断工具。对于部分撕裂可采用非手术治疗,而伸肌机制完全断裂通常需要手术修复。
一名年轻男性在跌倒后1个月出现无法行走的症状。他被诊断为双侧股四头肌肌腱断裂。进行了一期开放修复,随后使用双侧长腿膝关节支具。建议患者延迟负重,并开始进行股四头肌强化锻炼。
经过12个月的随访,与术前状态相比,患者的功能和活动范围有显著改善。双侧股四头肌肌腱断裂的一期开放修复被证明是一种有效的治疗方法,可实现满意的恢复并回归良好的功能结局。