Bilateral Concomitant Open Distal Femur Fractures Associated with Bilateral Quadricipital Tendon Rupture: A Case Report

Abstract

Fractures of the distal femur in young populations are usually due to a high-energy trauma mechanism. They often present with various associated osseous and soft tissue injuries. A case of bilateral open distal femur fractures with associated bilateral quadriceps tendon rupture is presented. This injury has not been previously reported in the literature. A 45-year-old male patient who sustained an axial injury to both his lower limbs after jumping from his house balcony while escaping a fire is presented. He was found to have bilateral open fractures of the distal femurs, associated with bilateral rupture of the quadriceps tendons. Both fractures were repaired via open reduction internal fixation using plate osteosynthesis. The quadriceps tendons were also repaired. Two years later, a persistent right femur nonunion was managed surgically with a re-do plate osteosynthesis and mesenchymal cell injection. The patient is in a good clinical condition after a follow-up of 5 years postoperatively. Rupture of the quadriceps tendon in association with distal femur fractures is a rare finding. However, understanding the mechanics and deforming forces of the fracture is crucial to explain the tendon injury. Open reduction internal fixation with primary repair of the quadriceps has led to successful outcomes in both lower limbs, with restoration of the patient’s baseline of motion and daily living.

Keywords

• distal femoral fracture
• bilateral
• uadriceps tendon rupture
• lower limb trauma
• bilateral
• open fracture
• non-union