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Case Series
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| Neglected ruptures of the patellar tendon: Repair options in a resource poor setting | ||||||
| Ikpeme A Ikpeme1, Anthonia A Ikpeme2, Innocent E Abang1, Paul O Amah2, Ahmed M Achaka3 | ||||||
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1Orthopaedics Unit, Department of Surgery, University of Calabar Teaching Hospital, P.M.B 1278, Calabar, Nigeria.
2Department of Radiology, University of Calabar Teaching Hospital, P.M.B 1278, Calabar, Nigeria. 3Nigerian Navy Hospital, Calabar, Nigeria. | ||||||
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| How to cite this article: |
| Ikpeme IA, Ikpeme AA, Abang IE, Amah PO, Achaka AM. Neglected ruptures of the patellar tendon: Repair options in a resource poor setting. International Journal of Case Reports and Images 2012;3(12):6–10. |
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Abstract
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Introduction:
Rupture of the patellar tendon is a disabling injury. Better results are reported in immediate repairs of fresh ruptures. In neglected ruptures, restoration of the structural and functional integrity of the extensor apparatus is difficult. This report highlights the use of an achilles osteotendinous autograft in the repair of an 8-month old neglected rupture of the patellar tendon; and the Mandelbaum technique with open tendon harvest in the repair of a 10-week old neglected rupture.
Case Series: A 23-year-old male presented with inability to extend the left knee; eight months after a road traffic accident. Physical and radiological findings were consistent with a rupture of the left patellar tendon. The patient was offered tendon reconstruction using an Achilles osteotendinous autograft from the contralateral lower limb. One year later, he was pleased with the outcome. A 29-year-old army officer presented with pain, swelling and inability to extend his right knee since 10 weeks. Physical and X-ray findings were in keeping with a rupture of the right patellar tendon. The patient was offered patellar tendon reconstruction using the Mandelbaum technique. Twenty-eight weeks postoperatively, the patient had a range of motion of 0–105° in the right knee and has since returned to a functional professional and recreational lifestyle. Conclusion: Neglected ruptures of patella commonly yield suboptimal results following repair. In resource-poor settings, an autogenous achilles tendon technique as well as the Mandelbaum technique may prove beneficial in the treatment of this difficult condition. | |
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Keywords:
Patellar tendon, Neglected rupture, Achilles osteotendinous autograft, Mandelbaum procedure, Resource poor setting
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Author Contributions
Ikpeme A Ikpeme – Substantial contributions to conception and design, acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Anthonia Ikpeme – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published Innocent Abang – Substantial contributions to conception and design, Drafting the article, revising it critically for important intellectual content, Final approval of the version to be published Paul O Amah – Substantial contributions to conception and design, Drafting the article, revising it critically for important intellectual content, Final approval of the version to be published Ahmed M Achaka – Substantial contributions to conception and design, Drafting the article, revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© Ikpeme A Ikpeme et al. 2012; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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