Traitement des ruptures négligées du tendon rotulien : à propos de deux cas

The authors report two cases of neglected patellar ligament rupture treated surgically. The repair was made by suture strengthened by a pedicled graft of quadriceps associated with a hooping with steel wire for the first case; and a reconstruction with free transplant bone-tendon-bone taken at the expense of the controlateral knee, supported by a centring with steel wire in 90° flexion for the second case. No postoperative immobilisation was made allowing beginning at once the re-education. The functional result was excellent on the active extension but with a residual stiffness concerning the flexion for the first patient. The surgical technique must be individually adapted; the centring of protection must be systematic but carefully realized to avoid the frequent abnormalities of location of the kneecap and the femoro-patellar conflicts and authorising a fast re-education. Through a review of the literature, we recall difficulties of care of this injury even on the diagnosis and therapeutic levels.