Disclosures: Perry Zelinger, MD: Nothing to disclose

Case Description: A previously independent 75-year-old male lawyer with past medical history of asymptomatic CLL not requiring treatment, hypertension, and hyperlipidemia sustained a fall down the subway stairs and ruptured bilateral quadriceps tendons. He underwent surgical repair two days after injury and was subsequently admitted to inpatient rehabilitation. His post-surgical instructions were to be in bilateral Bledsoe braces locked in extension for 2 weeks followed by 2 weeks of passive range of motion only. He was permitted to do isometric exercises and immediate weight-bearing as tolerated. On admission he was ambulating using a rolling walker and contact guard assist. His functional status progressed quickly to independent ambulation, however he was limited on lower extremity ADLs and sit to stand transfers from low seat heights due to his knees being locked in extension. This limitation was a barrier for safe discharge home given single living situation and lack of home support.

Setting: An acute inpatient rehabilitation center at a large academic institution

Patient: A previously healthy and independent 75-year-old man.

Assessment/Results: In consultation with his orthopedic surgeon, we modified his post-surgical precautions to allow early passive range of motion and extended his inpatient acute rehab stay to achieve a safe discharge home independently after 2 weeks.

Discussion: Simultaneous bilateral quadriceps tendon rupture is a rare occurrence and is seen spontaneously or after trauma. Of the less than 100 English language case reports in the literature, the majority had one or more known risk factor. The most common risk factors identified were chronic renal disease, diabetes, hyperparathyroidism, obesity, and steroid use.

Conclusion: We present a case of simultaneous bilateral quadriceps tendon rupture in a previously healthy 75-year-old man with no established risk factors.

Level of Evidence: Level V

« Back to AAPM&R Annual Assembly 2019

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/simultaneous-bilateral-quadriceps-tendon-rupture-a-case-report/