Traumatic quadriceps rupture in a patient with patellectomy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Acute traumatic, unilateral, quadriceps rupture after patellectomy is rare.</p> <p>Case presentation</p> <p>We present a 42-year old male who experienced a unilateral left quadriceps tendon rupture following assault by four people. Twenty-seven years before this injury, the patient had suffered ipsilateral femur and comminuted patellar fractures, which were managed by intramedullary nailing and patellectomy respectively. We performed primary end to end repair of the torn tendon. Postoperatively, histology revealed findings consistent with pre-existent degenerative changes. The patient made good recovery, and returned to his former occupation which was reliant on his ability to drive.</p> <p>Conclusion</p> <p>Degenerative changes of the tendon of the extensor mechanism of knee following patellectomy may predispose the quadriceps tendon to traumatic rupture. Early operative intervention and protracted rehabilitation are required to obtain the best functional results.</p

Percutaneous plating of ankle fractures

The management of distal tibial fractures can be difficult, and requires careful preoperative planning. Fracture pattern, soft tissue injury, and bone quality critically influence the selection of fixation technique.1 Several surgical methods have been described for the management of these fractures, including external fixation, intramedullary nailing, and plate fixation. External fixation may result in inaccurate reduction, malunion or nonunion, and pin tract infection.2Intramedullary nailing is considered the standard method to manage operatively diaphyseal fractures of the tibia, but the distal tibia poses concerns regarding the stability of fixation, the risk of secondary displacement of the fracture on insertion of the nail, breakage of nails and locking screws, and final alignment of the tibia