Joined: February 7, 2007
I am currently treating a physician (DO)that ruptured the quad tendon after slipping on some ice - was initially misdiagnosed and surgery was therefore performed a week or two later. Anyone know of outcomes with delayed surgery following a quad tendon rupture?
As a physician in has many questions and I want to be able to give him answers.
Any good ways to gain motion once he is allowed to progress beyond current restrictions (75 degrees passive flexion)
Joined: October 9, 2001
From: Pittsburgh, PA USA
I don't think a week or two delay is horrible, but the tissue stump may have adhered to underlying tissues during the delay
Once permitted to go past 75 deg, you just have to be careful about re-rupture. I've had quite a few of these patients, as other PTs defer them to our clinic. One recent patient had a re-rupture due to over zealous PT...fortunately he chose not to sue.
I spend a lot of time with patellar mobilization, scar tissue and extensor soft tissue mobilization, PRE's, and of course gentle prolonged static stretching.
John Duffy, PT OCS [URL=http://www.PTUpdate.com]www.PTUpdate.com[/URL]
John M. Duffy, PT Board Certified Orthopaedic Clinical Specialist www.PTupdate.com
I've treated four quad. tendon repairs in recent memory. I would speak with the surgeon, if possible, about the quality of the repaired tissue and the repair itself to give you a better idea of how cautious to be with your pt. . The greatest concern in delaying repair is tissue retraction which could effect the repair. I don't see a week or two causing a major problem. It's amazing, to me, how many times a quad. or patellar tendon rupture is missed until MRI or ortho. eval. .
If the surgeon has a protocol don't vary from it (without consulting the surgeon first) as that could be enough to be considered "over zealous" and if something were to happen it's the PT's fault...regardless of how good or bad the surgical result might have been.