Journal of Orthopaedic Case Reports最新文献

{"title":"Challenges and Solutions in Managing Recurrent Distal Tibia Interosseous Osteochondroma: A Case Study and Review of Literature.","authors":"Sandeep Kumar Yadav, Rajesh Kumar Rajnish, Aakarsh Aggarwal, Saurabh Gupta, Abhay Elhence, Anju G Chithira","doi":"10.13107/jocr.2024.v14.i12.5022","DOIUrl":"10.13107/jocr.2024.v14.i12.5022","url":null,"abstract":"<p><strong>Introduction: </strong>Osteochondroma, a common benign bone tumor, predominantly affects young individuals, with a higher prevalence in males. It typically manifests as a bony growth capped with cartilage near bone growth plates, often extending away from joints. While most cases are asymptomatic, some may present with pain, swelling, or mechanical complications necessitating surgical intervention. Recent research implicates genetic mutations, particularly in the EXT-1 gene, in osteochondroma development, with homozygous EXT1 deletion commonly found in sporadic cases.</p><p><strong>Case report: </strong>A 15-year-old girl presented to out patient department with recurrent osteochondroma in the distal tibia, an unusual location, with complications such as fibular deformation and ankle varus deformity. Initial surgery was performed elsewhere through an anterolateral approach, but the patient experienced persistent pain and serous discharge from the surgical scar. Examination revealed an unhealed scar with a discharging sinus and a firm, bony swelling on the left lower leg, along with a reduced range of motion. X-ray and MRI confirmed a pedunculated mass emerging from the distal tibial metaphysis, causing extraneous compression and deformity of the fibula without intraosseous infiltration. Histopathological examination of the resected specimen confirmed osteochondroma recurrence. Surgical management involved en bloc resection of the tumor and perichondrium through a posterolateral approach, with subsequent debridement of the previous surgical wound. Post-operative recovery was uneventful. Literature review indicates that observation is suitable for asymptomatic lesions, while symptomatic cases or those with concerning imaging findings may require surgery. Complications following surgical excision are reported, with recurrence rates ranging from 2% to 11.6%, highlighting the importance of complete resection to minimize relapse and risk of malignant transformation. Careful consideration is warranted in pediatric cases to prevent growth plate damage.</p><p><strong>Conclusion: </strong>Osteochondroma management involves tailored surgical intervention based on symptoms and imaging findings, with complete resection recommended to optimize outcomes and minimize recurrence, particularly in pediatric patients.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"14 12","pages":"66-72"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reverse Sleeve Placement in Complex Total Hip Arthroplasty for a Patient with Severe Valgus Deformity of the Trochanter-Surgical Technique and Case Report.","authors":"Rajshekhar K Thippana, Adarsh Krishna K Bhat","doi":"10.13107/jocr.2024.v14.i12.5006","DOIUrl":"10.13107/jocr.2024.v14.i12.5006","url":null,"abstract":"<p><strong>Introduction: </strong>It is rare to encounter a patient with severe valgus deformity of the greater trochanter with severe osteoarthritis of the hip joint. The treatment, that is total hip arthroplasty (THA) in such a case presents with a surgical challenge in proper placement of the femoral stem. Traditionally, an osteotomy procedure to correct the femoral deformity was warranted followed by THA. There are not many reported articles on such a case in English literature.</p><p><strong>Case report: </strong>A 75-year-old gentleman a known case of diabetes and hypertension, with a body mass index of 31.6 presents with a painful right hip joint. History reveals an osteotomy of the proximal femur done approximately 30 years back. After a thorough clinical and radiological examination, he underwent THA at our center.</p><p><strong>Discussion: </strong>Trochanter valgus deformity is a rare deformity to come across. Often femoral osteotomy is considered to correct the deformity to aid in the insertion of the femoral stem. In this report, we state a different technique wherein the sleeve of the S-ROM femoral component (DePuy Orthopedics, Warsaw, Indiana) is placed in reverse fashion to overcome this complex situation, negating the need for osteotomy correction.</p><p><strong>Conclusion: </strong>Deformity of the proximal femur can pose a significant technical challenge during THA. Modularity at the stem sleeve junction in the DePuy S-ROM system can prove to be efficient to secure good fixation in a femoral canal with deformities. Reverse sleeve placement proves to be reliable in the valgus deformity of the trochanter.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"14 12","pages":"27-31"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Modeling of Osteoarthritis Using Biochemical Markers: A Cross-Sectional Analysis.","authors":"Mani Arumugam, Chacko Paul Joseph P, Naveen Jeyaraman, Swaminathan Ramasubramanian, Rajeswary Hari, Madhan Jeyaraman","doi":"10.13107/jocr.2024.v14.i12.5084","DOIUrl":"10.13107/jocr.2024.v14.i12.5084","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoarthritis (OA) is a prevalent degenerative joint disease characterized by cartilage deterioration, joint pain, and reduced mobility. This study aimed to quantify the association between specific biochemical markers and OA and to develop a predictive model for assessing OA risk based on these markers.</p><p><strong>Materials and methods: </strong>A total of 200 participants (mean age: 55.2 years) were recruited for this cross-sectional analysis, conducted at Sri Lalithamabigai Medical College and Hospital between June and September 2023. The study included 100 patients with X-ray-confirmed knee OA and 100 healthy controls. Biochemical markers - Vitamin D, parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium, magnesium, chromium, and selenium - were measured using high-performance liquid chromatography tandem mass spectrometry, immunoassays, and inductively coupled plasma mass spectrometry. Statistical analysis involved independent t-tests and logistic regression, with model performance assessed by accuracy, precision, recall, F1-score, and area under the receiver operating characteristic (AUC-ROC).</p><p><strong>Results: </strong>The mean levels of the measured markers in the OA group were 19.82 ng/mL for Vitamin D, 58.10 pg/mL for PTH, and 135.70 IU/L for ALP, compared to 43.24 ng/mL, 23.73 pg/mL, and 53.13 IU/L, respectively, in controls. Significant differences were observed in Vitamin D, PTH, and ALP levels between OA patients and controls (P < 0.05). The predictive model demonstrated excellent performance, with an AUC-ROC of 1.00.</p><p><strong>Conclusion: </strong>The study identified significant associations between specific biochemical markers and OA. However, given the systemic influences on these markers, their role in predicting OA risk should be interpreted with caution. Further, research is needed to validate these findings and explore their potential in personalized OA management strategies.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"14 12","pages":"237-245"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alternative Management Approach for Infected Gap Non-Union of Both Bone Forearm - A Case Report.","authors":"I Muni Srikanth, Kalyan Deepak Sreenivas, Vineet Thomas Abraham, Pratik Talwar","doi":"10.13107/jocr.2024.v14.i12.5044","DOIUrl":"10.13107/jocr.2024.v14.i12.5044","url":null,"abstract":"<p><strong>Introduction: </strong>Infected gap non-union is a serious complication seen in cases of diaphyseal fracture of forearm bones. It carries high morbidity in the form of severe functional impairment and poses a challenge to treat due to the complex anatomical relationship and articulations involved. Though there are multiple treatment options available, there are no guidelines for its management. Each case is unique and requires a customized, patient-specific approach.</p><p><strong>Case report: </strong>A 43-year-old man sustained a road traffic accident with closed both bone forearm fracture 6 months ago and was treated elsewhere with open reduction plate fixation of the radius, and Kirchner wire fixation of the ulna at an outside centre. Subsequently, he developed a purulent discharging sinus from the surgical site. After 7 months, following a trivial injury, the patient developed a deformity in his forearm. X-ray findings revealed a bent radial plate, signs of osteolysis, implant loosening along with displaced shaft of ulna fracture. The patient underwent implant removal with radial shortening and plate osteosynthesis for the radius and ulna.</p><p><strong>Conclusion: </strong>In cases of infected gap non-union of radius and ulna, the key for management is thorough debridement with retention of vascularity by minimal soft tissue damage, followed by rigid fixation of the fracture. Simultaneously, adequate steps should be taken to manage the infection, such as culture-specific antibiotics and monitoring of inflammatory markers such as complete blood count, Erythrocyte sedimentation rate, and C-reactive protein.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"14 12","pages":"120-124"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revolutionizing Limb Preservation: A Case Report on Recurrent Fungating Giant Cell Tumor with Encased Radial Artery in the Distal Radius.","authors":"Kamal Kishor, Nitish Jagdish Jyoti, Love Kapoor, Venkatesan Sampath Kumar, Tahir Ansari, Shah Alam Khan","doi":"10.13107/jocr.2024.v14.i12.5064","DOIUrl":"10.13107/jocr.2024.v14.i12.5064","url":null,"abstract":"<p><strong>Introduction: </strong>Giant cell tumor (GCT) of the bone, although benign, poses significant challenges due to its locally aggressive nature and high recurrence rates post-surgical intervention. Among skeletal GCTs, those affecting the distal radius present unique difficulties, especially when fungating masses encase vital structures such as blood vessels.</p><p><strong>Case report: </strong>We present a case of a 28-year-old male with a recurring GCT of the distal radius, where limb-preserving surgery was successfully performed despite encasement of the radial artery. Surgical excision followed by wrist arthrodesis utilizing ulnar centralization resulted in satisfactory outcomes, emphasizing the importance of tailored surgical approaches for optimal functional preservation. Despite encountering local recurrence, subsequent excision and reconstruction utilizing vacuum-assisted closure and skin grafting achieved successful limb salvage with no evidence of further recurrence at the 18-month follow-up.</p><p><strong>Conclusion: </strong>This case study contributes valuable insights into rare limb salvage techniques applicable to challenging GCT presentations, advocating for personalized treatment strategies to mitigate recurrence risk and preserve patient quality of life.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"14 12","pages":"174-179"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of Detachment of Proximal Tibia Superficial Medial Collateral Ligament and Medial Meniscus Extrusion with Knee Osteoarthritis.","authors":"Woon-Hwa Jung, Aniket Wagh, Minseok Seo, Kishor Kunal","doi":"10.13107/jocr.2024.v14.i12.5086","DOIUrl":"10.13107/jocr.2024.v14.i12.5086","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study is to assess the correlation of detachment of proximal tibia superficial medial collateral ligament (sMCL) and medial meniscus (MM) extrusion with knee osteoarthritis (OA) and its progression.</p><p><strong>Materials and methods: </strong>This is a prospective study where 165 knees were evaluated using radiographs and magnetic resonance imaging for the severity of OA knee according to Kellgrence-Lawrence grading, MM extrusion, and status of proximal tibia attachment of sMCL. Chi-square test of Independence and Pearson's correlation test were used to assess any correlation among the variables.</p><p><strong>Results: </strong>The study population had a mean age of 52.93 ± 19.46 years. 106 (64.24%) were males and 59 (35.75 were females. There were 83 (50.30%) left knees and 82 (49.70%) right knees in the study. The percentage of proximal tibia sMCL detachment was more in patients with knee OA than those without OA (85-88.89%). Similarly, the percentage of MM extrusion was maximum in advanced arthritis patients (95%). Both these variables were lowest in non-arthritic group (2.56% and 6.41%, respectively). Statistical analysis showed a significantly positive correlation of detachment of proximal tibial attachment of sMCL as well as MM extrusion with grades of OA of knee (P < 0.001 for both).</p><p><strong>Conclusion: </strong>A detached proximal tibia sMCL and an extruded MM were individually found to have a strong association (Chi-square test) and a positive linear correlation (Pearson's test) with the arthritic condition of the knee. This would suggest a role of both these variables in the progression of knee OA. They can thus be used as prognostic markers for knee OA as well as an important target in the management of knee OA.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"14 12","pages":"246-251"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual Mobility in Extreme Situations of Revision Hip Arthroplasty: A Case Series of 3 Cases and Review of Literature.","authors":"Urvil Shah, Mohan Desai, Vinay Samant, Chandan Mehta","doi":"10.13107/jocr.2024.v14.i12.5068","DOIUrl":"10.13107/jocr.2024.v14.i12.5068","url":null,"abstract":"<p><strong>Introduction: </strong>Dual mobility (DM) total hip replacement (THR) features an acetabular component with an unconstrained tripolar build which ensures a greater range of motion without provoking any dislocation.We report three cases with extremes of surgical misadventure where we carried out a revision arthroplasty with a DM cup. The causes of the failure of the primary arthroplasty were multifactorial, even individually, and ranged from instability due to component malposition, trochanteric fracture, intrapelvic prosthesis protrusion, etc.</p><p><strong>Case report: </strong>(1) Case 1 is a 40-year-old male, who following a failed fixation of a right proximal femur shaft fracture had undergone a proximal femur replacement outside with a proximal femur bipolar prosthesis and presented with a dislocated prosthesis due to excessive anteversion of 40 of the stem. Revision was done by inserting a DM cup without revising the stem to preserve the valuable femoral bone stock. (2) Case 2 is an 84-year-old comorbid female, who had come with right protrusio acetabuli with bipolar prosthesis in situ. The patient was managed with bone grafting and insertion of a DM cup with a peripheral fit. Greater trochanter wiring was done for the greater trochanter fracture (GTF) along with prophylactic posterior column plating. (3) Case 3 is a 60-year-old male, who had left sided chronic THR instability. He has had three previous episodes of dislocation which started after 7 years, when the patient fell and had a GTF. Here, the causes of instability were multifactorial- GTF, malposition, and liner wear. Instead of using a constrained liner and predisposing the patient to impingement, we did an isolated revision with a DM cup only.</p><p><strong>Conclusion: </strong>The presented cases highlight the versatility and efficacy of utilizing a DM cup in revision arthroplasty for addressing diverse causes of primary hip arthroplasty failure. The adaptability is demonstrated in preserving the bone stock, managing bone loss, and addressing multifactorial instability, thereby emphasizing its widespread potential.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"14 12","pages":"185-191"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proximal Tibial Fracture in Pseudo-Rheumatoid Synovial Chondromatosis: A Case Study.","authors":"Utkarsh Tiwari, P Gopinath Menon, Sitsabesan Chockalingam","doi":"10.13107/jocr.2024.v14.i12.5058","DOIUrl":"10.13107/jocr.2024.v14.i12.5058","url":null,"abstract":"<p><strong>Introduction: </strong>Progressive pseudorheumatoid dysplasia is an autosomal recessively inherited rare disorder with features of growth retardation, multiple joint deformities, and intra-articular loose bodies.</p><p><strong>Case report: </strong>This case study is about a 34-year-old man who presented to us following trauma to his right leg. On general assessment, he was short statured with multiple deformities of both upper and lower limbs with local signs suggestive of proximal tibial fracture over his right tibia. Blood values indicated low Vitamin D levels with normal serum calcium and alkaline phosphatase, inclusive of the inflammatory markers. X-rays showed platyspondyly, decreased bone stock, and significant joint space narrowing in addition to the displaced proximal tibial meta-diaphyseal fracture. He was managed surgically and went on to have an uneventful post-operative period with fracture healing but with a need for further intervention in the future to address his associated secondary knee arthritis.</p><p><strong>Conclusion: </strong>To share the morphometrics and presentation of this rare disease. And to highlight the role of psychological and rehabilitative therapy in improving the disease outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"14 12","pages":"159-163"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study on Outcome of Conservative Management of Shaft Humerus Fracture: A Case Report.","authors":"Tushar Gupta, Sharib Shamim, Afroz Ahmed, Vipin Gupta, Gourav Mazumdar, Akansha Vaish","doi":"10.13107/jocr.2024.v14.i12.5088","DOIUrl":"10.13107/jocr.2024.v14.i12.5088","url":null,"abstract":"<p><strong>Introduction: </strong>Conservative or surgical treatment options are available for humeral shaft fractures. To pinpoint individuals who would benefit from early surgical fixation, fracture characteristics were examined. In conservative treatment, the \"U\" slab prevents displacement, and overriding is corrected by gravity while the patient continues to move about. Rotation is prohibited for 14 days by holding the arm immobile to the chest with the elbow flexed. The preferred course of treatment for fractures of the humeral shaft at all levels is the hanging cast.</p><p><strong>Materials and methods: </strong>This study was conducted at Eras Lucknow Medical College and Hospital. Forty patients with Humerus shaft fractures (HSF) who met the inclusion criteria and presented in casualty or outpatient department participated in the study. This prospective cross-sectional study was of 24 months duration.</p><p><strong>Statistical analysis: </strong>Descriptive statistical analysis was performed to calculate the mean with corresponding standard deviations (s.d.). Test of proportion was used to find the standard normal deviate (Z) to compare the difference.</p><p><strong>Results: </strong>The ratio of male and female (Male: Female) was 3:1. Test of proportion showed that the proportion of males (75.0%) was significantly higher than that of females (25.0%) (Z = 7.07; P < 0.001). Thus, in this study, the males were at higher risk of having fracture shaft of humerus than females. Right-sided fractures (57.5%) were significantly higher than left-sided fractures (42.5%) (Z = 2.12; P = 0.034). About 72.5% of the patients were with disabilities of the arm, shoulder, and hand (DASH) score between 14 and 16 which was significantly higher than other DASH scores (Z = 3.30; P < 0.0001).</p><p><strong>Conclusion: </strong>Our observation regarding this study is that conservative management of HSF can be opted as the most effective way of treatment, and any complications due to any untoward event during the operative treatment should be limited.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"14 12","pages":"252-256"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Traumatic Rupture of the Quadriceps Tendon - A Case Report.","authors":"Baibhav Mishra, Manish Raj, Sudarsan Behera, Janki Sharan Bhadani, Rajeev Kumar, Pawan Kumar","doi":"10.13107/jocr.2024.v14.i12.5010","DOIUrl":"10.13107/jocr.2024.v14.i12.5010","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Case report: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"14 12","pages":"36-40"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}