rupture
(rŭp'chŭr 
)
[L. ruptura, breaking]
- A tearing apart of an organ or tissue.
SEE: illus.Acute rupture of the biceps tendon, with bruising.
- A colloquial term for a hernia.
SEE: hernia..
r. of the Achilles tendon Rupture of the attachments of the gastrocnemius and soleus muscles to the posterior calcaneus, typically occuring in middle-aged male athletes participating in basketball or other ball sports, some divers, or patients treated with steroid injections for Achilles tendinitis.
The injury typically occurs during sudden, forceful plantar flexion of the ankle.
After an initial sensation of being struck in the back of the lower limb, the patient typically reports an inability to push up onto his or her tiptoes. The injury is distinguished from others by placing the patient in a prone position with feet extending off the foot of the examining table. The examiner then squeezes the calf muscle and observes the response: if plantar flexion occurs, the tendon is intact; if ankle dorsiflexion results, the tendon is partially intact; if no flexion of any kind occurs, the tendon is ruptured (the Thompson Test).
Management may involve casting the lower extremity, but usually surgical repair or reinforcement of the damaged tendon is required.
The patient is taught to keep the leg elevated for 48 to 72 hr after the injury, with ice applied intermittently to the joint (or cast) to help control swelling. Nonsteroidal anti-inflammatory drugs are provided for pain and inflammation. The patient is fitted for crutches or a walker-frame and instructed in gait training. Rehabilitation exercises consist of flexibility, strengthening, and balance exercises as tolerated. Assisted motion of the ankle reduces the duration of rehabilitation from rupture of the Achilles tendon, which may in some instances be prolonged or complicated by muscle atrophy or repetitive injury to the tendon.
attrition r.Rupture of a tendon due to repetitive rubbing of the tendon on nearby bones, joints, or fracture edges.
cardiac r.Rupture of the heart muscle after severe chest trauma (or in approx. 2% of patients who have suffered a myocardial infarction). It typically results in sudden cardiac death or tamponade. SYN: myocardial rupture .
effort r. of the esophagus Boerhaave syndrome.
extracapsular r.Rupture of the contents of a surgical implant beyond the scar tissue that grows to surround it.
ABBR: ROM
Rupture of the amniotic sac as a normal result of dilation of the cervix uteri in labor. SYN: amniorrhea.SEE: preterm premature rupture of membranes.
r. of perineum Spontaneous rupture of the perineum during the second stage of labor. This occurs more commonly in primiparas and may be avoided by having an episiotomy.
plaque r.Rupture of a lipid-rich lesion from the wall of a blood vessel. The damage this does triggers a cascade of events that result in blood clot formation within the vessel and its eventual obstruction. This is the immediate cause of acute myocardial infarction.SYN: cap rupture.
SEE: premature rupture of membranes.
preterm premature r. of membranes
SEE: under premature rupture of membranes.
silent r.1Asymptomatic or unrecognized rupture of the contents of a surgical implant into surrounding tissues.2Asymptomatic rupture or protrusion of the contents of a cavity or structure.
splenic r.An abdominal catastrophe marked by severe, often pleuritic pain, hemodynamic instability, blood loss into the peritoneum, and occasionally cardiovascular collapse and death. It may occur as a result of trauma or rarely in patients with infectious mononucleosis. Treatment may be conservative or may involve removal of the spleen. In delayed rupture of the spleen, a catastrophic illness may not present until days or weeks after the causative injury.
Variant: rupture of the tubes
A rupture of a fallopian tube, a surgical emergency in ectopic pregnancy. This may occur without the woman's knowing that she is pregnant.r. of the tympanic membrane Rupture of the epithelium that separates the external auditory canal from the middle ear. This can be caused by of trauma or more often as a consequence of a middle ear infection.
Variant: rupture of the uterus
A rare condition in which the uterine muscles are ruptured by the stresses of unrelieved obstructed labor, the parting of an old cesarean delivery scar, or aggressive induction or augmentation of labor.SEE: cephalopelvic disproportion; induction of labor.