Damir Matoković

A Case Report of Spontaneous Concurrent Bilateral Rupture of the Quadriceps Tendons in a Patient With Chronic Renal Failure

In patients with chronic renal failure, many complications may develop that involve all organ systems, especially the locomotor system. Spontaneous concurrent bilateral rupture of the quadriceps tendons is a very rare complication in patients with chronic renal failure, usually occurring in patients under 50 years of age. Although there are numerous causes that lead to tendon weakness and rupture, most authors agree that secondary hyperparathyroidism plays a major role in the pathogenesis of tendon rupture. Soft tissue and perivascular calcifications, diminished local circulation, reduced tendon elasticity, impaired collagen metabolism, nerve lesions, repeated trauma, and articular swelling contribute to tendon weakness and rupture. A patient is presented in whom spontaneous concurrent bilateral quadriceps tendon rupture occurred at the age of 34, after seven years of hemodialysis therapy. Timely diagnosis and operative management with primary tendon suturing followed by physiotherapy produced a good anatomical and functional result.

P121 – 2636: Electroencephalographic abnormalities in children with mild traumatic brain injury

Objective Mild traumatic brain injury (MTBI) is a complex patophysiologic process affecting the brain, induced by traumatic biomechanical forces. The aim of this retrospective study is to determine the frequency and degree of electroencephalographic (EEG) abnormalities in children with MTBI without morphological brain impairment. Methods 114 participants between six months and 17.5 years of age have been admitted to Department of Surgery at General County Hospital, Požega, Croatia, between June 1st 2006 and February 1st 2011. Out of 114 participants, 74 (66%) were boys and 38 (34%) were girls. On each participant an EEG was performed within 24 hours after admission. Results EEG recording performed right after the injury was normal in 67 (58.8%) of cases and abnormal in 47 (41.2%) cases. From all abnormal recordings, EEG in 19 (16.6%) patients demonstrated diffuse dysrhythmia. Slowing was present in 13 (11.4%) EEGs (five diffusely and eight focally slowed). Paroxysmal EEG abnormalities were present in six (5.2%) patients. Focal spikes have been registrated in nine (7.8%) cases. Conclusion The study shows that children without morphological brain impairment may have EEG abnormalities directly after MTBI. It suggests that neuronal impairment occurs even in absence of observed intracranial pathology.