TITLE:
Management of Simultaneous Bilateral Quadriceps Tendon Ruptures with Ipsilateral Achilles Tendon Rupture: A Case Report
AUTHORS:
Daniel Mossalbaye Adendjingue, Valentin Andjeffa, Allamine Hassan Adoum, Magloire Dingamnodje, Moussa Kalli, Service Minguemadji, Adoumbaye Djimtolnan, Oswald Goukodadja, Rimtebaye Kimasoum
KEYWORDS:
Tendon Rupture, Transosseous Reinsertion, Immobilization, Case Report
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.16 No.9,
September
28,
2026
ABSTRACT: Introduction: Concurrent ruptures of several major tendons of the lower limbs are exceptional. They can be post-traumatic or related to metabolic or drug-induced factors. Their management is complex and requires optimal functional rehabilitation. Clinical Case: We report the case of a 40-year-old hypertensive patient treated with amlodipine, who, following indirect trauma in a road accident, presented with complete functional impairment of the lower limbs. Examination revealed a triple tendon rupture: a complete bilateral rupture of the quadriceps tendon at the level of the patella (Caton-Deschamps index of 0.40 on the right and 0.45 on the left) and a rupture of the right Achilles tendon 1 cm from its insertion. On postoperative day 16, the patient underwent a single-stage surgery. The Achilles tendon was sutured with axial transosseous sutures in the prone position. The two quadriceps tendons were reinserted in the supine position using vertical patellar transosseous tunnels. Strict plaster cast immobilization was maintained for 45 days. At 34-month follow-up, the patient is walking independently with a slight right-sided limp. Extension is complete and symmetrical. Flexion is 130˚ on the left and limited to 100˚ on the right. The right ankle is mobile. Ultrasound reveals microcalcifications of scar tissue on the three operated tendons and the contralateral healthy Achilles tendon. Conclusion: Reinsertion using transosseous tunnels combined with 6 weeks of immobilization is a reliable strategy for securing these injuries.