rupture

Management

Surgical Algorithm

 

Stage 1 Tendonitis

 

Non-operative

 

Walking cast / NSAIDS

- 6/52

 

UCBL

- 3/12

- worn inside the shoe

- ends under malleoli

- controls the heel (which must be flexible)

- supports the arch

 

Operative / Synovectomy and debridement

(+/- FDL transfer and calcaneal osteotomy +/- T Achilles lengthening)

Quadriceps Rupture

Epidemiology

 

Usually occurs in patients over 60

- due to decreased vascularity & collagen weakness

 

Younger patient on steroids / growth hormone

 

Occasionally occurs in young athlete with excessive contracture

 

Aetiology

 

Often preceded by quadriceps tendinosis

 

Patella Tendon Rupture

Epidemiology

 

Usually occurs in young people

- often previous history of tendonitis ± steroid injections

 

Location

 

Usually at level of inferior pole of patella

- less common at tibial tubercle

- mid-substance ruptures rare

 

Clinical

 

Severe pain

Palpable defect

Extensor deficit / unable to SLR

 

Xray

 

Patella alta / high riding patella