Introduction: Rectus femoris muscle injuries are common in sports. Although majority of these injuries are treated conservatively, some tend to present significant disability which could compromise the returning to pre-activity level of competition in athletes. The purpose of this study is to evaluate possible benefits of operative treatment in acute and recurrent rectus femoris ruptures. Methods: Retrospectively, a total of 27 patients (23 men, 4 women) with grade 4 rectus femoris muscle rupture which located at the diaphyseal area between proximal and distal myotendinous junctions. Operative treatment was carried out in the acute (8 cases, < 4 weeks after injury) or recurrent rectus femoris ruptures (19 cases). Results: 20 (74%) patients had excellent or good results, moderate results in 6 (26 %) and poor (required re-operation after re-injury) in 1 (4%) patients. The return to pre-activity level of competition was 5 months on average. Adverse events were haematoma (n=4, percutaneously drained), superficial infection (n=1, healed with cephalexin antibiotics), partial dehiscence of the wound (n=1, no intervention).
Conclusion:Based on these cases, excellent or good results may often be expected after surgical repair of grade 4 rectus femoris midsubstance ruptures. Level of evidence: IV, Case series.