No abstract

Spontaneous unilateral quadriceps tendon rupture is an uncommon injury that is generally associated with chronic kidney disease and metabolic disorders. The current case involved a 50-year-old man with a painful right knee that he was unable to extend as a result of minor trauma sustained in an accident. Physical examination combined with radiographic and ultrasonographic investigations led to a diagnosis of quadriceps tendon rupture of the right knee. The patient had a 7-year history of hemodialysis for treatment of chronic kidney disease, leading to secondary hyperparathyroidism. He underwent successful tendon repair surgery, and his right knee was immobilized with splints for 6 weeks postoperatively. He gradually resumed full weight bearing and then normal walking.

The low-energy ‘Logsplitter’ fracture, caused by a sprain or fall, is characterized by an intact or slightly separated inferior tibiofibular joint. Compared with the high-energy ‘Logsplitter’ fracture, this atypical subtype is rarely seen and is easily missed. Here, the case of a 33-year-old male patient with a fractured right ankle as a result of a sprain during walking is reported. The patient initially received routine surgical treatment comprising internal fixation of the fibular, medial and posterior malleoli. Unexpectedly, post-surgery imaging examinations revealed that the medial clear space of the right ankle had widened to 6 mm, due to incomplete reduction of the lateral malleolus, shortening and rotation of the fibula, and an unreduced avulsion fracture block of the anterior malleolus. A revision surgery was then performed to anatomically reduce and fix the lateral malleolus, as well as the anterior malleolus avulsion fracture. During 5 months following surgery, the patient achieved good fracture union and functional restoration of the right ankle. For this rare injury, the present case demonstrates that complete restoration of the fracture is required to achieve good clinical efficacy.