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This case report describes a 38-year-old male with concomitant parathyroid adenoma presenting with bilateral quadriceps tendon rupture, emphasizing prompt diagnosis to enable appropriate treatment. Management included open repair of both quadriceps tendons, removal of the parathyroid adenoma, and a structured physiotherapy protocol. Favorable functional recovery was noted at 6 months, highlighting multidisciplinary care.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/fractured-connection-unmasking-primary-hyperparathyroidism-through-bilateral-quadriceps-tendon-rupture-case-report/447566/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/fractured-connection-unmasking-primary-hyperparathyroidism-through-bilateral-quadriceps-tendon-rupture-case-report/447566.png","ImageObject",300,407,{"name":92,"@type":93},"ahduag","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is early recognition important in bilateral spontaneous quadriceps tendon rupture?","Question",{"text":112,"@type":113},"Early recognition enables prompt diagnosis and initiation of appropriate treatment, which improves outcomes in this rare condition.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What treatment did the 38-year-old male receive for bilateral quadriceps tendon rupture with parathyroid adenoma?",{"text":117,"@type":113},"He underwent open repair of both quadriceps tendons, surgical removal of the parathyroid adenoma, and a planned physiotherapy protocol.",{"name":119,"@type":110,"acceptedAnswer":120},"What outcome was observed during follow-up?",{"text":121,"@type":113},"A favorable functional outcome was observed during the 6-month follow-up period.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},447566,1790765146,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},3985747870414,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Case Report  Journal of Orthopaedic Case Reports 2025 December:15( 12) :Page 120-124   \nFractured Connection: Unmasking Primary Hyperparathyroidism through Bilateral Quadriceps Tendon Rupture –ACase Report  \nIM Maqbal Muhasin Nazar1, Sharafuddeen Mammu1, VH Nidhin Chacko1, Rahul Chandran1,  \nAshwin Rajamohanan1, Shaneed Karinkappara2  \nLearning Point of the Article:  \nEarly recognition, surgical intervention, and specialized rehabilitation are pivotal in effectively managing bilateral spontaneous quadriceps tendon rupture with concurrent parathyroid adenoma, emphasizing the importance of a comprehensive approach for optimal patient  \noutcomes.  \nAbstract  \nIntroduction: Bilateral spontaneous quadriceps tendon rupture (QTR) is extremely rare. This condition involves the simultaneous tear of the fibrous tissue connecting the quadriceps muscle to the patella bone. The importance of prompt diagnosis is emphasized, as early recognition is crucial for initiating appropriate treatment and achieving optimal outcomes.  \nCase Report: This article presents a case report detailing the management of bilateral QTR alongside concomitant parathyroid adenoma in a 38-year-old male. The patient underwent open repair of both bilateral quadriceps tendons, followed by a well-planned physiotherapy protocol. Furthermore, surgical removal of the parathyroid adenoma was performed. A favourable functional outcome was observed during the 6-month follow-up period.  \nConclusion: This case report highlights the critical aspects of managing bilateral spontaneous quadriceps rupture alongside concomitant parathyroid adenoma. Addressing the diagnostic and management challenges associated with this rare condition underscores the importance of early diagnosis, prompt surgical intervention, and tailored rehabilitation programs. This comprehensive approach contributes to the existing literature and emphasizes the significance ofmultidisciplinary collaboration in achieving favourable patient outcomes.  \nKeywords: Primary hyperparathyroidism, quadricepsrupture, adenoma, rehabilitation.  \nIntroduction  \nQuadriceps muscles are the principal extensors ofthe knee joint. The quadriceps femoris inserts into the patella through a shared tendon structured in three layers: The rectus femoris lies most superficially, followed by the vastus medialis and vastus lateralisin the intermediate layer, with the vastus intermedius deepest. Quadriceps tendon rupture (QTR) is a rare but debilitating condition characterized by the sudden rupture of the quadriceps  \ntendon. While this injury is commonly attributed to direct trauma, a subset of cases presents spontaneously, without apparent cause.  \nSpontaneous quadriceps rupture was first described by Steiner and Palmer [1]. These spontaneous ruptures pose a diagnostic challenge and may signify an underlying systemic disorder. Only over 100 cases of spontaneous QTR have been reported worldwide. Spontaneous rupture can occur in degenerative  \n\n| \u003Cbr>Access this article online\u003Cbr>\u003Cbr>Website: [www.jocr.co.in](www.jocr.co.in)\u003Cbr>\u003Cbr>DOI:\u003Cbr>[https://doi.org/10.13107/jocr.2025.v15.i12.6474](https://doi.org/10.13107/jocr.2025.v15.i12.6474) | Author’s Photo Gallery |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- |\n|  | \u003Cbr>Dr. I M Maqbal Muhasin Nazar | \u003Cbr>Dr. Sharafuddeen Mammu | | | | \u003Cbr>Dr. Shaneed Karinkappara |\n|  | \u003Cbr>1Department of Orthopaedics, Government Medical College, Kozhikode, Kerala, India, 2Department of Orthopaedics, National Hospital, Kozhikode, Kerala, India.\u003Cbr>Address of Correspondence:\u003Cbr>Dr. Maqbal Muhasin Nazar I.M.,\u003Cbr>Department of Orthopaedics, Government Medical College, Kozhikode, Kerala, India.. [E-mail:](E-mail: maqbal21@gmail.com)[ maqbal21@gmail.com](E-mail: maqbal21@gmail.com) |  |  |  |  |  |\n| Submitted: 19/09/2025; Review: 16/10/2025; Accepted: November 2025; Published: December 2025 |  |  |  |  |  |  |\n| DOI: [https://doi.org/10.13107/jocr.2025.v15.i12.6474](https://doi.org/10.13107/jocr.2025.v","cbCairS8JxBWtqyO","https://ap.wps.com/l/cbCairS8JxBWtqyO","pdf",8343025,"English","# Abstract\n## Introduction\n## Case Report\n## Conclusion\n## Introduction (Anatomy and Background)\n## Laboratory Investigations\n## Case Report (Patient Presentation)","[{\"question\":\"Why is early recognition important in bilateral spontaneous quadriceps tendon rupture?\",\"answer\":\"Early recognition enables prompt diagnosis and initiation of appropriate treatment, which improves outcomes in this rare condition.\"},{\"question\":\"What treatment did the 38-year-old male receive for bilateral quadriceps tendon rupture with parathyroid adenoma?\",\"answer\":\"He underwent open repair of both quadriceps tendons, surgical removal of the parathyroid adenoma, and a planned physiotherapy protocol.\"},{\"question\":\"What outcome was observed during follow-up?\",\"answer\":\"A favorable functional outcome was observed during the 6-month follow-up period.\"}]","Fractured Connection - Unmasking Primary Hyperparathyroidism through Bilateral Quadriceps Tendon Rupture - Case Report | PDF",1790721449,13]