Incomplete rupture of the quadriceps tendon with complete rupture of the vastus intermedius: Case report and brief review of relevant literature
Bibliographic record
Abstract
Introduction: Rupture of the quadriceps tendon is an uncommon injury with an incidence of 1.37/100000. Incomplete rupture is characterized as having an intact extensor mechanism while complete rupture presents with an inability to extend the knee. Incomplete ruptures are typically treated non-operatively whereas complete ruptures require surgical intervention. Existing literature reporting partial tears of the tendon is limited. Specifically, isolated vastus intermedius tendon injury has been reported in two case reports thus far. The purpose of this report is to outline the rare case of an incomplete quadriceps tendon rupture with complete rupture of the vastus intermedius, treated with early surgical repair that resulted in an excellent patient outcome. Methods: A 35-year-old male truck driver presented with right knee pain, joint effusion, and decreased range of motion following an injury while jumping in a basketball game. Ultrasonography revealed a partial-thickness tear of the quadriceps tendon with complete rupture of the vastus intermedius. MRI confirmed the diagnosis of a high-grade partial-thickness complete tear involving 60% of the quadriceps tendon with significant retraction of the vastus musculature. It is the opinion of the senior author (JA) that this injury pattern combined with his known extensor lag was unlikely to improve without surgical intervention. This was discussed with the patient and they underwent successful quadriceps tendon repair.Results: Six months post-operatively, the patient had no pain with rest or walking. He had returned to work without limitation. On examination, his gait was normal and knee range of motion was full. There was no tenderness to palpation over the quadriceps tendon and no crepitus with movement. Straight leg raise and single-leg squatting were performed without difficulty. The patient’s quadriceps muscle bulk was approximately 80% of the contralateral side and his power was 5/5.Discussion: This report outlines the rare case of complete vastus intermedius avulsion from the quadriceps tendon, with partial tendon rupture. Similar injuries have traditionally been managed non-operatively. We illustrate how surgical repair can be performed successfully with an excellent clinical outcome. An understanding of predisposing factors for partial tears can also be gained through review of the literature.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".