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      Estudo epidemiológico das rupturas tendinosas do mecanismo extensor do joelho em um hospital de nível I Translated title: Epidemiological study on tendon ruptures of the knee extensor mechanism at a level 1 hospital

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          Abstract

          OBJETIVOS: O propósito do presente estudo é revisar aspectos epidemiológicos das rupturas tendinosas do aparelho extensor do joelho em hospital de nível I. MÉTODOS: Analisamos, retrospectivamente, 76 lesões do mecanismo extensor do joelho, tratadas cirurgicamente no Hospital Municipal Miguel Couto, no período de março de 2004 a março de 2011. Levamos em consideração idade, sexo, mecanismo de trauma, classificação anatômica da lesão, lado acometido, comorbidades e lesões associadas. RESULTADOS: Dos pacientes estudados, 68 eram do sexo masculino, com idade média de 36 anos. Quanto ao mecanismo de trauma, 62 foram por trauma direto, 21 casos foram do lado direito, oito apresentavam comorbidades e quatro tiveram lesões associadas. CONCLUSÕES: A maioria dos pacientes foi do sexo masculino, na faixa etária economicamente ativa (jovens), e vítima de trauma direto, sendo as rupturas do ligamento patelar as lesões mais comuns. Lesões associadas são raras, e as comorbidades foram pouco frequentes em nossa casuística.

          Translated abstract

          OBJECTIVES: The purpose of the present study was to review the epidemiological aspects of tendon ruptures of the knee extensor apparatus at a level 1 hospital. METHODS: We retrospectively ana lyzed 76 lesions of the knee extensor apparatus that were treated surgically at the Miguel Couto Municipal Hospital between March 2004 and March 2011. We took into consideration age, sex, trauma mechanism, anatomical classification of the lesion, affected side, comorbidities and associated lesions. RESULTS: Among the patients studied, 68 were male and the mean age was 36 years. Regarding the trauma mechanism, 62 lesions occurred due to direct trauma; the right side was affected in 21 cases; eight presented comor bidities and four presented associated lesions. CONCLUSION: The majority of the patients were male, at an economically active age (young people), and were victims of direct trauma. Ruptures of the patellar ligament were the most frequent lesions. Associated lesions were rare and comorbidities were infrequent in our sample.

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          Quadriceps tendon rupture.

          Rupture of the quadriceps tendon is an uncommon yet serious injury requiring prompt diagnosis and early surgical management. It is more common in older (>40 years) individuals and sometimes is associated with underlying medical conditions. In particular, bilateral spontaneous rupture may be associated with gout, diabetes, or use of steroids. Clinical findings typically include the triad of acute pain, impaired knee extension, and a suprapatellar gap. Imaging studies are useful in confirming the diagnosis. Although incomplete tears may be managed nonsurgically, complete ruptures are best treated with early surgical repair.
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            Patellar tendon ruptures.

            Isolated rupture of the patellar tendon is a rare injury. Often occurring during a fall in 20- and 30-year olds, patients may have a preexisting medical condition (eg, history of steroid use) or a history of repetitive microtrauma to the knee. A high-riding patella on physical examination and radiographs is pathognomonic. Immediate orthopaedic referral for surgical repair is necessary to reestablish knee extension. Delay in diagnosis can make surgical treatment more difficult. Current methods of postoperative rehabilitation are evolving. Evaluative studies based on rating scales show satisfactory clinical and functional results after surgery. However, time lost from work and recreation may be protracted, and quadriceps atrophy is often evident. Ruptures of the patellar tendon should be diagnosed acutely and immediately referred to an orthopaedic surgeon. The impact of the injury to the patient may be long-standing even after operative treatment. Contemporary surgical and rehabilitative techniques give the best opportunity for restoration of functional activity.
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              Ultrasonography as a reliable diagnostic tool in old quadriceps tendon ruptures: a prospective multicentre study.

              Quadriceps tendon rupture is an uncommon injury. In the majority of cases, predispositions as recurrent microtrauma or degenerative changes are present. The diagnosis of acute quadriceps tendon ruptures can usually be made by clinical examination. Ultrasonography has been shown as a reliable, inexpensive and easily available diagnostic tool to confirm the diagnosis. In this study, we evaluated the clinical value of ultrasonography for establishing diagnosis of old quadriceps tendon ruptures. In the prospective time period of 6 years (01/1998-12/2003), the delayed diagnosis of quadriceps tendon rupture was established in six patients with seven cases of old ruptures (one bilateral rupture). The mean age was 50.2 (SD+/-16.9) years in one woman and five men. The mean interval from trauma until diagnosis was 15.2 (SD+/-7.1; range 8-24) weeks. In all cases, ultrasonography represented a reliable and sensitive tool for establishing diagnosis of old quadriceps tendon rupture. We therefore recommend the use of ultrasonography in the diagnostic work up of cases with knee trauma and potential involvement of tendon injuries.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbort
                Revista Brasileira de Ortopedia
                Rev. bras. ortop.
                Sociedade Brasileira de Ortopedia e Traumatologia (São Paulo )
                1982-4378
                2012
                : 47
                : 6
                : 719-723
                Affiliations
                [1 ] Hospital Municipal Miguel Couto Brazil
                [2 ] HMMC Brasil
                [3 ] HMMC Brasil
                [4 ] Santa Casa da Misericórdia do Rio de Janeiro Brazil
                Article
                S0102-36162012000600008
                10.1590/S0102-36162012000600008
                b9a51a31-edc4-4ec6-9f0a-47b6f6a1cb95

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0102-3616&lng=en
                Categories
                ORTHOPEDICS

                Orthopedics
                Epidemiology,Knee,Rupture,Epidemiologia,Joelho,Ruptura
                Orthopedics
                Epidemiology, Knee, Rupture, Epidemiologia, Joelho, Ruptura

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