Investigation and treatment for isolated vastus intermedius rupture

Complete disruption of vastus intermedius tendon and partial rupture of vastus medialis tendon

Quadriceps tendon ruptures are common injuries, however isolated ruptures are rare. Particularly, reports for isolated vastus intermedius ruptures are very scarce. We present a case of a 62-years-old male patient who sustained a complete rupture of vastus intermedius tendon with a partial rupture of vastus medialis while rectus femoris tendon was intact, after a fall from standing height. Due to lag in extension, surgical treatment was performed, consisted of an end-to-end Krakow suture technique accompanied with two anchors placed on osseous attachment to the superior pole of the patella. A hinged knee brace locked in full extension was applied for 4 weeks. Gradual range of flexion was suggested after the 3rd postoperative week. Full range of motion was achieved in the 7th postoperative week.

Structural diversity of the vastus intermedius origin revealed by analysis of isolated muscle specimens

The quadriceps femoris (QF), a major extensor of the knee joint, plays an important role in human movement. However, descriptions of the three vastus muscles of the QF in anatomy textbooks remain confusing. We analyzed 33 QFs by a novel approach, using isolated muscle specimens to clarify the structures of the vastus lateralis (VL), vastus medialis (VM), and vastus intermedius (VI) origins. The origins of the VL and VM were quite constant in shape and location, but the VI was much more structurally diverse. In typical cases (23 of 33), the origin of the VI attached muscularly to the anterior and lateral surface of the femoral shaft. It adjoined the origin of the VL at the lateral lip (LL) of the linea aspera to form a common origin. In some cases (10 of 33), the muscle belly and origin of the VI were much smaller than those in the typical cases; the origin of the VI attached only to the anterior surface of the femur and did not contact the LL. In addition, the muscle belly of the VI was narrow and almost corresponded to the width of the femoral shaft. The isolated muscle specimen is a useful tool for analyzing individual muscle structures, which can be difficult to observe by routine dissection. Using this method, it became clear that the VI is more structurally diverse in its origin than the VL and VM. Clin. Anat. 30:98-105, 2017. © 2016 Wiley Periodicals, Inc.