Quad Rupture Assessment - PT Exam

In today's video Quad Rupture Assessment-PT Exam we have a 55 y/o male who sustained a quad rupture pushing a boat into the water. Here I will explain...
✅ The mechanism of injury.
✅ Where the swelling is most prominent.
✅ How to perform a quad rupture assessment
✅ My proposed management of this patient and so much more!
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#Quadrupture #KneeExam #OrthoEvalPal #MCL#SpecialTests #Orthopedics #physicaltherapy #physicaltherapytests #knee #kneepain #kneeexam #kneeinjury

[@Mjzzz11]

Nice catch

[@triplevitalitytv4260]

Really nice vid Paul thank you!

[@OrthoEvalPal]

Glad you enjoyed it!

[@SHANEShanerton]

Very interesting. I went 9 years with a partial quad tendon tear. Had my knee scoped and it was never the same after. I knew something was wrong. No ortho would do an mri to see what was up. Finally I found someone to do one. I'm a 26 year old female with no injury or anything like that to have suspected. Dr is hesitant on surgery but looks like I am headed that way

[@cwebbhouston]

I have had a partial quad tendon tear for about 15 or so years now. I'm wondering if there is something I can do to get it fixed.

[@Daninvietnam]

Good luck mike hope you’re well on your way to recovery

[@OrthoEvalPal]

Hi Dan, Mike is doing awesome!! Almost graduated from PT.

[@MojoMoneyMajor]

​@@OrthoEvalPal did he need surgery?

[@OrthoEvalPal]

@@MojoMoneyMajor yes! Most awkward ruptures need to have surgery, but if they wait, too long, surgery may not be feasible because the tissue won’t be strong enough to hold

[@maheshchowdhary3354]

1) focal hyperintensity in the cartilage 3x1mm with underlying subchondral marrow contusion/edema measuring 1.2x1.1cms in size in the lateral femoral condule - s/o low grade osteochondral injury. 2)small sized pockets of fluid collection under the LCL and FCL with diffuse increased signal intensity of LCL seen however fibre continuity is maintained - s/o grade II injury. 3)inflamatory/edematous changes with fluid signal intensity in the hoffa's fat pad. 4)focal grade I signal intensity in the anterior horn of lateral meniscus. 5)Tiny hyperintense signal(4mm) involving cartilage of medial femoral condyle. 6) Minimal joint effusion seen extending into medial and lateral recess and adjacent to anterior horn of lateral meniscus

[@mysticalpathmysticalpath602]

Did you have surgery or only therapy? Hope you are better.

[@Su-ks1qb]

Do quad strains cause inner thigh pain?

[@wileymatthews96]

If the diagnosis is correct would it be mandatory for patient to have surgery, or since its only partial could he continue with conservative treatments? Thanks!

[@OrthoEvalPal]

Yes so the diagnosis was correct and he did have surgery. A quad rupture is very disabling. I've never seen one "not" fixed. Good question Wiley!

[@drtravispenrod]

Did he come in directly to you? I had a patient who I suspected a fracture sent in from a physician and the physician was not happy that I tried to send him back. After some back and forth, they finally did an image and sure enough, he had a fracture. I'm just curious if the physician sent him in with a diagnosis or if you got direct access to him. Thanks!

[@OrthoEvalPal]

He came to me with knee contusion. I do get a lot of direct access which I prefer especially in sticky situations like this. There are ways to approach it if you are quite confident that it is what you think it is.

[@MissKae_85]

🤔 I fell down stairs a few days back and just had quadricep tendon repair surgery today (full tear). Wondering what I’ll be able to do in 4 weeks. How often was Mike doing physio sessions?

[@TimothyC.84]

I hate Mike had to tear his quad for your video 😅

[@Pete.Ty1]

👍👍👍

[@OrthoEvalPal]

You are welcome Pete!

[@BODIFY-PT]

How can i treat without a surgery as it is a partial rupture

[@OrthoEvalPal]

It is possible.

[@BODIFY-PT]

@@OrthoEvalPal but how

[@dunkstruction8036]

@@BODIFY-PT rest and rehab exercises, you can even wear a brace if you want to

[@samkitty5894]

This is really nothing. He's got lots of motion and little pain. Just take some NSAID pills and let the tings fall in place, as they should, and will. There is no quad tendon tear here. Stop pushing unneeded surgeries.

[@AlAl-en9ce]

I agree. This guy did have a surgery apparently but this was something that could be fixed without it.

[@OrthoEvalPal]

Sorry but this guy could not function at all!!! I have never seen a full thickness quad rupture heal itself. Any chance this has happened to you and it healed? If so, I would love to know about it.

[@oceanbackwards1903]

damn you can't walk without your quads my guy lmao. tendons have a hard time healing in the first place, and with all that muscle swelling there is no way the tendon would've even had the chance to make any contact with the muscle in order to heal