Neglected ruptures of the patellar tendon: about 24 cases

Dr Hicham EL HYAOUIa, Dr Haitam ABOUALIa, Dr Hakim AIT LAHSSENa, Prof Abderrahim RAFAOUIa, Prof Abdeljabbar MESSOUDIa, Prof Mohamed RAFAIa, Prof Abdelhak GARCHa, Dr Karima BELHAJb, Dr Naima EL AMRANIb, Dr Aziza NAIT KHCHATb, Prof Fatima LMIDMANIb, Prof Abdellatif EL FATIMIb

a Service de traumatologie-orthopédie, pavillon 32, centre hospitalier universitaire Ibn-Rochd. Casablanca. Maroc, b Service de médecine physique et de réadaptation fonctionnelle. Centre hospitalier universitaire Ibn-Rochd. Casablanca. Maroc

Objectives. The subject of this work is to clarify the epidemiological, clinical, therapeutic and prognostic of neglected rupture of the patellar tendon.

Patients and methods. A retrospective study of 24 cases of neglected rupture of patellar tendon, treated between June 2000 and June 2012.

Results: Our patients were 13 men and 10 women. The average age was 33 years, ranging from 21 to 52 years. Eight patients were followed for systemic diseases. The mean time to consultation was 52 days (28 days to three months). The diagnosis was done through imaging. Surgical exploration specified that the rupture was total in 19 cases, partial in five cases and located at the infra-patella in fourteen cases. All patients were operated. The repair of the lesions were made by using a fascial flap from quadriceps in 19 cases and a plasty with the semitendinosus tendon in five cases. In all cases, the tendon was put to rest and protected by a metal framing for a period. Distant results were evaluated after a mean of 27 months by Kelly and Dubourg clinical and radiological criteria. The result was fair in 18 cases and poor in 5 cases.

Discussion-Conclusion. The results of our work allowed us to conclude that the neglected rupture of the patellar tendon was the prerogative of the young and active adult. The only treatment is surgical. The major prognosis factor is the length of duration of the lesion. Early postoperative rehabilitation is of a great interest and determines the functional prognosis.

Keywords : Patellar tendon; Neglected rupture; Surgery; Rehabilitation