My Quadriceps Tendon Torn Asunder

Surgery, Quadriceps tendon tear: with my kneecap slipped down below the joint, if you look closely and you can see the end of femur. So the day before the previous entry, December 23rd, I was stepping off the bus around the corner from where I teach English here in Ho Chi Minh City, Viet Nam, when the quadriceps tendon in my right leg completely tore away from my patella – the tissue that connects my thigh muscles to my kneecap.

I was stepping down onto the last step of the bus prior to stepping off onto the pavement when I heard a snap and fell onto the street, landing on my left side. Immediately I thought the bus’ stairs must have broken or otherwise collapsed – this particular Sai Gon bus happened to be pretty ramshackle. I looked over my shoulder back at the bus, but the steps were intact. Then I tried to stand up, and realized something was dreadfully wrong.

I could feel my lower right leg, but I couldn’t move it – nothing happened when I tried to move it, much less put weight on it. What’s more, I could see, even through my pants leg, that my patella was no longer where it should be, that it was in fact now located well below and to the left of the knee joint (if you were looking at my knee) – it was literally resting on top of the ends of my shin bones.

I specifically remember thinking, as I lay there in the gutter: “Oh fuck. That’s not right.”

About this time it started to hurt. Yet it didn’t hurt as much as one might think, thanks to the process of going into shock. I’ve only experienced this twice before, and the last time was more than 10 years ago. I had forgotten just how unpleasant it is – I’d rather deal with the pain than having to alternate between trying not to pass out and trying not to puke.

It was an interesting taxi-ride to the hospital, to say the least.

Now before anyone asks, no, the bus was not moving when this happened; it had actually come to a complete stop before I had descended its steps (this isn’t always the case with public buses here in Viet Nam). And as it turns out there was no organic reason for this to happen, apparently; no heretofore undiagnosed degenerative disease or other orthopedic problem. Rather, it is just chalked up to “one of those things,” i.e. random chance – “I stepped wrong.” Apparently my foot caught in such a way that my forward and downward momentum combined along with the position of my foot to tear my quadriceps tendon in twain.

I suspect it might have something to do with the half sandal/slipper shoe that I wear – make that past tense – wore to class, something that I could easily kick off during class, as I loathe shoes with a passion (one of many reasons to return to this part of the world). Perhaps my foot slipped ever so slightly at just the right moment. But I really don’t know; there seemingly is no reason for this – other than karma, perhaps – and this is the most maddening aspect of this whole experience – one of many, to be sure.

Just a random Yuletide Fuck You from the Universe. Once more: well played, Christmas.

 But What’re These Gory Pictures? A Few Notes on the Surgery

My surgically repaired quadriceps tendon. Now my patella is where it should be.

Eeewww! Gross! Or, perhaps, cool! Fascinating! It all depends on which end of the squeamish spectrum you reside, I suppose. As you can guess, I live on the latter end. I find stuff like this endlessly fascinating, although I admit, given that it’s my blood and flesh cut open, the first time I viewed these images it did make me somewhat uncomfortable for a brief moment.

Anyway, my orthopedic surgeon here at Ho Chi Minh City’s FV Hosptial, Dr. Phat – cuz Phat is where it’s at — was kind enough, at my request, to snap a few photos during my surgery. These aren’t just any surgery photos, Dear Gentle Reader; that’s the interior of my knee laid open for you to see, in all it’s bloody and torn glory.

If you look closely at the first image above — go ahead, click on it, and enjoy the bloody hi-rez gore — you can actually see into my knee joint, and consequently the end of my femur. That’s because my patella, or kneecap, is nowhere to be seen; it’s still residing below the joint, just beyond the end of the incision (to the right of the image, which is in the direction of my foot; my thigh is oriented to the left). Dr. Phat — or a nurse or some other assistant — has the end of my torn quadriceps tendon in the forceps on the left of the image.

Frankenknee: 36 hours after surgery to repair a quadriceps tendon tear.In the second image, my tendon is all stitched up and reattached to my patella. Note you can no longer see down into the knee joint — that’s the way it is supposed to be. There are actually two different layers of sutures or stitches; again, if you look closely you can see some of these (they happen to be blue). I’ve forgotten to ask Dr. Phat three times now how exactly the sutures are connected to the patella, but from my research into the surgery I gather he likely drilled some holes into the bone.

Neato, huh? This final image over here on the right is my leg, all stitched up and put back together again, about 36-hours after surgery.