Difference between revisions of "Quadriceps tendon rupture"

(Created page with "==Background== *Occurs via forceful contraction of quadriceps muscle or falling on flexed knee *Typically occur 2cm from insertion on patella {{Patellar vs Quadriceps tendon...")
 
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*Sudden "pop" or tearing
 
*Sudden "pop" or tearing
 
*Diffuse swelling
 
*Diffuse swelling
*Defect may be palpable above or below the patella
+
*Defect may be palpable above the patella
 
*Partial tears lead to difficulty extending the knee
 
*Partial tears lead to difficulty extending the knee
 
*Complete tears lead to absent straight leg raise while supine or extension of the knee again
 
*Complete tears lead to absent straight leg raise while supine or extension of the knee again
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**Separation of the tendon can be visualized
 
**Separation of the tendon can be visualized
 
*X-ray
 
*X-ray
**Patella alta (or high-riding patella) is consistent with patella tendon rupture
+
**Patella baja/infera (low-riding patella)
**Patella baja/infera (or low-riding patella) is consistent with quadriceps tendon rupture
 
  
 
==Management==
 
==Management==

Revision as of 06:09, 5 January 2017

Background

  • Occurs via forceful contraction of quadriceps muscle or falling on flexed knee
  • Typically occur 2cm from insertion on patella

Patellar vs Quadriceps tendon rupture

Finding Patellar tendon rupture Quadriceps tendon rupture
Location Distal to patella Proximal to patella
Typical group Patients <40yr with history of tendinitis or steroid injections Patients >40yr
X-ray Patella alta (high-riding patella) Patella baja/infera (low-riding patella)

Clinical Features

  • Sudden "pop" or tearing
  • Diffuse swelling
  • Defect may be palpable above the patella
  • Partial tears lead to difficulty extending the knee
  • Complete tears lead to absent straight leg raise while supine or extension of the knee again

Differential Diagnosis

Knee diagnoses

Acute knee injury

Nontraumatic/Subacute

Evaluation

  • Ultrasound
    • Separation of the tendon can be visualized
  • X-ray
    • Patella baja/infera (low-riding patella)

Management

  • Ortho consult in the ED
  • Knee immobilizer, can be weight bearing
  • Operative repair advised within 7 days

Disposition

See Also

References

  • Uptodate
  • Wheeless' Textbook of Orthopaedics