Traumatic quadriceps rupture in a patient with patellectomy: a case report.
BACKGROUND
Acute traumatic, unilateral, quadriceps rupture after patellectomy is rare.


METHODS
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.


CONCLUSIONS
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.
Shanmugam
Chezhiyan
C
Department of Trauma & Orthopaedic Surgery, University Hospital of North Staffordshire, Keele University School of Medicine, Stoke-on-Trent, ST4 6QG, UK. schezhiyan@gmail.com.
Maffulli
Nicola
N