Partial rupture of the quadriceps muscle in a child

Abstract

BackgroundThe quadriceps femoris muscle ruptures usually occur in the middle-aged population. We present a 4-year-old patient with partial rupture of the quadriceps femoris muscle. To our knowledge, this is the youngest patient reported with a quadriceps femoris muscle rupture.Case PresentationA 4-year-old girl admitted to our clinic with left knee pain and limitation in knee movements. Her father reported that she felt pain while jumping on sofa. There was no direct trauma to thigh or knee. We located a palpable soft tissue swelling at distal anterolateral side of thigh. The history revealed that 10 days ago the patient was treated for upper tract respiratory infection with intramuscular Clindamycin for 7 days. When we consulted the patient with her previous doctor and nurse, we learnt that multiple daily injections might be injected to same side of left thigh. MRI showed a partial tear of vastus lateralis muscle matching with the injection sites. The patient treated with long leg half-casting for three weeks. Clinical examination and knee flexion had good results with conservative treatment.ConclusionsMultiple intramuscular injections may contribute to damage muscles and make prone to tears with muscle contractions. Doctors and nurses must be cautious to inject from different parts of both thighs.

A rare knee extensor mechanism injury: Vastus intermedius tendon rupture

“…Thus, we have preferred conservative treatment. Similarly, Aydemir et al claimed that they had good results with conservative treatment by keeping the injured extremity in cast for 3 weeks [8] , Weber et al also reported that they have conservatively treated a patient with isolated distal rectus femoris tendon rupture and had good functional outcome [7] .…”

“…Also, disorders such as renal insufficiency, hyperparathyroidism, romatoid arthritis, obesity, gout and systemic lupus erythematosus may induce ruptures [14–16] . On the other hand, trauma is the main etiology in the young population [6,8,17] . The most common mechanism for this injury is eccentric overloading of the extensor mechanism when the knee is flexed with plantar flexion of the foot [4] .…”

“…These are usually full thickness injuries. There is a limited number of studies in the literature, reporting partial quadriceps tendon ruptures [6–9] . Also we did not find any study reporting an isolated vastus intermedius tendon injury in the literature.…”

Total rupture of the quadriceps muscle in an adolescent

“…In the immature skeleton, the muscles, ligaments and tendons are generally stronger than the growth plates 2 . In our patient, a lesion was observed in the upper center of the patella, with hemarthrosis of the knee, thus demonstrating the traumatic and acute nature of the injury.…”

Quadriceps muscle rupture mimicking lumbar radiculopathy

“…Aydemir and colleagues [14] recently reported a case of vastus lateralis muscle partial tear after intramuscular injection in a child.…”