Abstract
his is a case report of a patient who experienced a right quadriceps tendon rupture.
The patient, a 36-year-old female, has been suffering from renal osteodystrophy and secondary hyperparathyroidism. She has been undergoing hemodialysis treatment since March 1976. On February 7, 1984, a snowy day, she slipped and fell on the street hitting the right knee joint hard. She has complained of pain and difficulty in walking since then. She was admitted to the hospital immediately, whereupon X-ray findings showed a dislocation of the patella which was diagnosed as being a right quadriceps tendon rupture. On March 14, an anastomosis operation was performed under spinal anesthesia. The tendon was found to be completely ruptured. On May 23, a subtotal parathyroidectomy was performed under general anesthesia. A histological examination revealed parathyroid adenoma (excised organ weight 7, 500mg). The results of a bone biopsy revealed osteitis fibrosa.
The direct cause of the tendon rupture was the contusion she experienced when she slipped and fell on the street. However, it was largely due to the weakened condition of the tendon caused by secondary hyperparathyroidism and acidosis, both of which were caused directly by chronic renal failure.
Until recently cases of tendon rupture in hemodialysis patients have been relatively rare. However, nowadays, with the increase in long-term hemodialysis patients, corresponding increase in the percentage of such cases in quite possible. Sufficient care should be taken for patients undergoing hemodialysis treatment over a prolonged period.
