Neglected Quadriceps Rupture Managed with Polypropylene Mesh and Collacure: A Case Report

Abstract

Background: Quadriceps muscle rupture is second common cause of disrupted extensor mechanism by directly affect lower limb function by hinders knee extension drastically. Ideally, patient with quadriceps tendon rupture and undergo primary surgical repair in first 48–72 hours after injury to achieve good outcome then decrease morbidity and disability. Chronic untreated quadriceps tendon rupture with adverse progression of gap cause by muscle contraction, scarred muscle body, degenerative calcification, or decreased tendon end vascularity lead to pain in contraction, worsening morbidity and disability as well makes surgical repair more technically challenging. We report one case of chronic untreated quadriceps muscle rupture, our management, and outcomes. Clinical case: 27 years old male with right quadriceps rupture that occurred accidently while he was descending stairs. The patient then went to bonesetter and just went to the hospital after a long time of complaints of pain and are not getting better. In the right knee, the neglected quadriceps rupture was managed with polypropylene mesh and collacure to shorthen the gap. Discussion: Management goal is to reduce large gap at quadriceps tendon to reach both end of the muscle in tension free manner and not only increasing regeneration of tendon but also increasing the strength of the tissues after healing by polypropylene mesh and collacure. Conclusion: Quadriceps reconstruction with polypropylene mesh and collacure have a fair result for extensor mechanism. Further research is required to determine best approach to quadriceps reconstruction in reducing gap.