Kronik böbrek yetmezlikli bir hastada bilateral kuadriseps ve triseps tendon kopması ile akromioklavikular eklem seperasyonu
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Date
2013-11-11
Authors
Küçükalp, Abdullah
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Publisher
Uludağ Üniversitesi
Abstract
Biletaral kuadriseps tendon spontan rüptürü nadir görülen sıklıkla kronik hastalığı olan hastalarda ortaya çıkan klinik bir durumdur. Kronik böbrek yetmezliği ve buna bağlı hemodializ tedavisi gören hastalar da risk altındaki hastalardır. Kronik böbrek yetmezliği olan ve hemodializ tedavisi gören hastalarda amiloid birikimi ve üremik toksinlerin etkisi ile tendonlarda zayıflama gelişir. Bunun yanısıra bu hastalarda azalmış fosfor atılımına bağlı gelişen sekonder hiperparatiroidizm de kemik rezorpsiyonu yaparak kemik tendon yapışma yerlerinden kopmalara yol açabilir. Olgumuz 8 yıldır kronik böbrek yetmezliği için hemodializ tedavisi gören bir hastadır. Hastada spontan gelişen bilateral kuadriseps, sol triseps tendon kopması ve takip eden dönemde düşme sonrası gelişen sağ akromioklaviküler eklem seperasyonu oluşmuştur. Sonuç olarak KRY’ li hastaların çok basit travmalarla veya hafif zorlamalarla bile kas tendon yaralanmalarına açık hastalar olduğu bilinmeli, acil serviste veya poliklinikte değerlendirdiğimiz hastaların anamnezinde böbrek yetmezliği ve hemodializ tedavisi varsa bu hastaları daha dik katli muayene etmemiz ve şüphelendiğimiz olgularda tetkik istemekten çekinmememiz gerektiği kanaatindeyiz.
Bilateral spontaneous rupture of the quadriceps tendon is a rarely seen clinical condition occuring in patients with chronic diseases. Patients with chronic renal insufficiency and undergoing haemodialysis associated with that are at risk. Weakening of the tendons develops with the accumulation of amyloid and uremic toxins in patients with chronic renal insufficiency and undergoing haemodialysis. In addition, secondary hyperparathyroidism, which develops from decreased phosphorous discharge in these patients, can lead to tendon rupture by causing bone resorption. The case presented here is a patient with an 8-year history of haemodialysis due to chronic renal insufficiency. Bilateral quadri ceps rupture developed spontaneously in the patient, with the rupture of the left triceps tendon and after a fall in the follow-up period, the right acromioclavicular joint separation occurred. In conclusion, as patients with chronic renal insufficiency are known to be vulnerable to tendon injuries from simple trauma or even mild force, if there is renal insufficiency and haemodialysis in the patient anamnesis taken in the emergency department or polyclinic, there should be more careful examination and no hesitation in requesting tests for suspicious patients.
Bilateral spontaneous rupture of the quadriceps tendon is a rarely seen clinical condition occuring in patients with chronic diseases. Patients with chronic renal insufficiency and undergoing haemodialysis associated with that are at risk. Weakening of the tendons develops with the accumulation of amyloid and uremic toxins in patients with chronic renal insufficiency and undergoing haemodialysis. In addition, secondary hyperparathyroidism, which develops from decreased phosphorous discharge in these patients, can lead to tendon rupture by causing bone resorption. The case presented here is a patient with an 8-year history of haemodialysis due to chronic renal insufficiency. Bilateral quadri ceps rupture developed spontaneously in the patient, with the rupture of the left triceps tendon and after a fall in the follow-up period, the right acromioclavicular joint separation occurred. In conclusion, as patients with chronic renal insufficiency are known to be vulnerable to tendon injuries from simple trauma or even mild force, if there is renal insufficiency and haemodialysis in the patient anamnesis taken in the emergency department or polyclinic, there should be more careful examination and no hesitation in requesting tests for suspicious patients.
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Keywords
Kuadriseps tendon rüptürü, Akromioklaviküler eklem seperasyonu, Kronik böbrek yetmezliği, Triseps tendon rüptürü, Quadriceps tendon rupture, Chronic renal insufficiency, Triceps tendon rupture, Acromioclavicular joint separation
Citation
Küçükalp, A. vd. (2013). "Kronik böbrek yetmezlikli bir hastada bilateral kuadriseps ve triseps tendon kopması ile akromioklavikular eklem seperasyonu". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 39(3), 185-188.