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Emergency Department Evaluation: Thigh Injuries

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Emergency Department Evaluation: Thigh Injuries

Emergency Department Evaluation: Thigh Injuries

Quadriceps Tendon Rupture

Quadriceps (or extensor tendon) rupture results from powerful muscle contractions secondary to a fall or in conjunction with severe ligamentous disruption at the knee. This is typically an injury seen in older patients, but it may occur in younger patients involved in jumping activities.43 In athletes, the rupture most often occurs in high-power sports events, such as the high jump, basketball, and weightlifting. 44 Patients report hearing a loud pop and are immediately unable to extend the leg or bear weight. They may complain of buckling of the knees or inability to walk up stairs or up an incline.45 Often there is a palpable soft-tissue defect proximal to the superior pole of the patella, but this may be obscured by edema.43 All patients have marked weakness of the knee extensors, and most have an inability to perform a straight leg raise test when supine. Radiographs of the knee may reveal a poorly defined suprapatellar mass, an obliterated quadriceps tendon, and a joint effusion.45 Early diagnosis is important, as surgical repair within 48-72 hours is necessary to preserve the extensor mechanism of the knee.43

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