Bilateral patellar tendon rupture in a child: a case report

Abstract

Patellar tendon rupture in children is very rare. When it occurs, patellar tendon is usually ruptured either from the upper end as a sleeve fracture of the patella or from lower end as an avulsion fracture of the tibial tuberosity. In this report, we present the case of an otherwise healthy 9-years-old boy who had subsequent bilateral patellar tendon ruptures through the midparts, which has not been published previously in the literature. Treatment was performed with primary end-to-end repair, reinforcement with cerclage wires and fresh-frozen achilles tendon augmentation for both sides.

Bilateral Tibial Tubercle Sleeve Fractures in a Skeletally Immature Patient

“…These patellar tendon ruptures can occur in its midsubstance or as sleeve avulsions from the patella or the tibial tubercle. Muratli et al [6] described a case of simultaneous bilateral midsubstance rupture in a 9-year-old boy following a fall. Kim et al [7] described a case of 12-year-old boy with bilateral simultaneous avulsion of patellar tendon from inferior pole of patella which required surgical intervention.…”

Spontaneous bilateral patellar tendon rupture: a case report and review of the literature

“…Moreover, this injury is very rare in the paediatric age group and more frequent in adolescents [1][2][3][4]. At the proximal end it is associated with a sleeve fracture, whereas at the distal end it is a tibial tuberosity avulsion rather than a middle-substance tear [5]. Bilateral ruptures are most infrequent and often are associated with systemic or chronic diseases [6] such as systemic lupus erythematosus (SLE) [7], rheumatoid arthritis [8], chronic renal failure [9], hyperparathyroidism [10] or prolonged corticosteroid treatment [11].…”

Concurrent bilateral patellar tendon rupture in a preadolescent athlete: a case report and review of the literature

“…In addition, most spontaneous ruptures occur at the proximal insertion site not the mid-portion, and in case of systemic disease, it can occur at any portion [3,8]. This explains that repetitive forces are mostly placed on the insertion site.…”

“…Bilateral patellar tendon rupture is often related to systemic disease, such as rheumatoid disease, renal failure and lupus erythematosus, as well as steroid use [1,6]. Concurrent bilateral patellar tendon rupture in preadolescence is also extremely rare, which is the reason why there was less opportunity for children to expose their knee to strong forces of which 17.5 times the body weight is required to cause rupture in healthy patients [7], Only one case has been reported in the English language literature [8]. However, it involved a subsequent patellar tendon rupture, not a concurrent one as in our case.…”