title: A case report of spontaneous concurrent bilateral rupture of the quadriceps tendons in a patient with chronic renal failure.
abstract: In patients with chronic renal failure, many complications may develop that involve all organ systems, especially the locomotor system. Spontaneous concurrent bilateral rupture of the quadriceps tendons is a very rare complication in patients with chronic renal failure, usually occurring in patients under 50 years of age. Although there are numerous causes that lead to tendon weakness and rupture, most authors agree that secondary hyperparathyroidism plays a major role in the pathogenesis of tendon rupture. Soft tissue and perivascular calcifications, diminished local circulation, reduced tendon elasticity, impaired collagen metabolism, nerve lesions, repeated trauma, and articular swelling contribute to tendon weakness and rupture. A patient is presented in whom spontaneous concurrent bilateral quadriceps tendon rupture occurred at the age of 34, after seven years of hemodialysis therapy. Timely diagnosis and operative management with primary tendon suturing followed by physiotherapy produced a good anatomical and functional result.
authors.affiliation: Department of Orthopedics, County General Hospital Pozega, Pozega, Croatia. damir.matokovic@po.t-com.hr
authors.forename: Damir
authors.initials: D
authors.lastname: Matokovic
authors.forename: Boris
authors.initials: B
authors.lastname: Matijasevic
authors.forename: Petar
authors.initials: P
authors.lastname: Petrić
authors.forename: Tomislav
authors.initials: T
authors.lastname: Crnkovic
authors.forename: Sanja
authors.initials: S
authors.lastname: Skorvaga
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D006435:Renal Dialysis; D012422:Rupture, Spontaneous; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D013848:Thigh / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography