Banjade Rishi Ram, Dhakal Sandesh, Bhandari Dependra, Sharma Niraj Kumar
Kathmandu Medical College and Teaching Hospital Kathmandu Nepal.
Department of Orthopaedics Kathmandu Medical College and Teaching Hospital Kathmandu Nepal.
Clin Case Rep. 2025 Jun 2;13(6):e70545. doi: 10.1002/ccr3.70545. eCollection 2025 Jun.
Quadriceps tendon ruptures (QTR), often involving the rectus femoris due to its superficial position, primarily affect men aged 50-60 with comorbidities weakening tendon collagen. Tears typically occur 1-2 cm above the patella or at the osteotendinous junction in older adults. Rupture of the rectus femoris muscle can sometimes mimic a pseudotumor, presenting as a soft tissue mass in the anterior thigh, with or without a clear history of trauma. In chronic cases, unrecognized or repetitive microtrauma often leads to fibrosis and incomplete healing. Isolated distal ruptures of the rectus femoris are rare, especially in young athletes. Differential diagnosis should rule out soft tissue tumors or sarcoma. Systemic diseases, obesity, or long-term steroid/quinolone use may contribute to ruptures, though in our cases, no such factors were found, suggesting old age is a potential risk. Nonsurgical healing is slow, leading to scar tissue and hindering recovery. Surgical repair is critical to prevent poor outcomes in untreated or chronic ruptures and to restore knee extensor function.
股四头肌肌腱断裂(QTR),由于股直肌位置表浅,常累及股直肌,主要影响50至60岁患有合并症且肌腱胶原蛋白减弱的男性。撕裂通常发生在髌骨上方1 - 2厘米处或老年人的骨腱交界处。股直肌断裂有时可模拟假肿瘤,表现为大腿前部的软组织肿块,有无明确外伤史均可。在慢性病例中,未被识别或反复的微创伤常导致纤维化和愈合不完全。孤立的股直肌远端断裂很少见,尤其是在年轻运动员中。鉴别诊断应排除软组织肿瘤或肉瘤。全身性疾病、肥胖或长期使用类固醇/喹诺酮类药物可能导致断裂,不过在我们的病例中,未发现此类因素,提示老年是一个潜在风险。非手术愈合缓慢,会导致瘢痕组织并阻碍恢复。手术修复对于预防未经治疗或慢性断裂的不良后果以及恢复膝关节伸肌功能至关重要。