Bilateral Rupture Research Articles

The Multi‐Segment Complexity of the 2024 MW ${M}_{W}$ 7.5 Noto Peninsula Earthquake Governs Tsunami Generation

AbstractThe 1 January 2024, moment magnitude 7.5 Noto Peninsula earthquake ruptured in complex ways, challenging analysis of its tsunami generation. We present tsunami models informed by a 6‐subevent centroid moment tensor (CMT) model obtained through Bayesian inversion of teleseismic and strong motion data. We identify two distinct bilateral rupture episodes. Initial, onshore rupture toward the southwest is followed by delayed re‐nucleation at the hypocenter, likely aided by fault weakening, causing significant seafloor uplift to the northeast. We construct a complex multi‐fault uplift model, validated against geodetic observations, that aligns with known fault system geometries and is critical in modeling the observed tsunami. The simulations can explain tsunami wave amplitude, timing, and polarity of the leading wave, which are crucial for tsunami early warning. Upon comparison with alternative source models and analysis of 2000 multi‐CMT ensemble solutions, we highlight the importance of incorporating complex source effects for realistic tsunami simulations.

Simultaneous Bilateral Quadriceps Tendon Rupture in A Diabetic Patient: A Rare Case Report and Surgical Technique

Simultaneous Bilateral Quadriceps Tendon Rupture in A Diabetic Patient: A Rare Case Report and Surgical Technique

Refractory Nephrotic Syndrome Resulting in Bilateral Achilles Tendon Rupture Due to Relapse by Vaccination after Recovery from COVID-19: A Case Report

Refractory Nephrotic Syndrome Resulting in Bilateral Achilles Tendon Rupture Due to Relapse by Vaccination after Recovery from COVID-19: A Case Report

Simultaneous Bilateral Quadriceps Tendon Rupture in a Patient Undergoing Long-Term Hemodialysis: A Case Report

Bilateral quadriceps tendon ruptures are rare lesions. At.raumatic forms, or those following low-energy trauma, are much rarer and occur on pre-existing lesions. We report a case of bilateral and simultaneous rupture of the quadricipital tendon in a 45-year-old hemodialysis patient with secondary hyperparathyroidism (PTH: 1642 pg /ml). He underwent surgical repair with good evolution after rehabilitation. Spontaneous and simultaneous bilateral ruptures of the quadricipital tendon are exceptional. A pathology that weakens the tendons, such as secondary hyperparathyroidism, which is common in dialysis patients, remains the most common cause.

Bilateral triceps rupture: a review of the literature and case series

Introduction Distal triceps tendon injuries are the least common of tendon injuries, comprising 1% all cases. This injury is more common in active men, between 30-50 years old. Risk factors include anabolic steroid use, local steroid injections and hyperparathyroidism. The principal mechanism of injury is an eccentric load applied to a contracting triceps. This injury is often misdiagnosed and thus far, bilateral injury has not been reported. Methods Retrospective description of two patients diagnosed with bilateral distal triceps injury with different presentations, treated surgically at a surgical center in the USA. Electronic records were reviewed for patient demographics, rehabilitation and clinical outcomes. Discussion The triceps tendon may be weakened by stem cell or corticoid injections or may cause tendinosis. Early diagnosis and surgical repair with a Krackow-type suture configuration in the triceps and parallel bone tunneling is a safe technique with a secure repair. Graded rehabilitation can offer patients good outcomes for range of motion and strength. Clinicians can explain that patients can expect to return to sport and activity. Conclusion Triceps tendon rupture is a rare, significant injury that requires a secure surgical repair with bone tunnelling. Our experience careful post-operative rehabilitation with gradual motion and strengthening is the key for successful recovery.

Super-shear ruptures steered by pre-stress heterogeneities during the 2023 Kahramanmaraş earthquake doublet

The 2023 M7.8 and M7.5 earthquake doublet near Kahramanmaraş, Turkey, provides insight regarding how large earthquakes rupture complex faults. Here we determine the faults geometry using surface ruptures and Synthetic Aperture Radar measurements, and the rupture kinematics from the joint inversion of high-rate Global Navigation Satellite System (GNSS), strong-motion waveforms, and GNSS static displacement. The M7.8 event initiated on a splay fault and subsequently propagated along the main East Anatolian Fault with an average rupture velocity between 3.0 and 4.0 km/s. In contrast, the M7.5 event demonstrated a bilateral supershear rupture of about 5.0–6.0 km/s over an 80 km length. Despite varying strike and dip angles, the sub-faults involved in the mainshock are nearly optimally oriented relative to the local stress tensor. The second event ruptured a fault misaligned with respect to the regional stress, also hinting at the effect of local stress heterogeneity in addition to a possible free surface effect.

Relocation of the 2021 MW 7.4 Maduo, Qinghai, China earthquake sequence and implications for seismogenic structure

An MW 7.4 earthquake struck Maduo County, Qinghai, China on 22 May 2021. To better understand the seismogenic structure of this region, we collect local earthquake arrival time data at the MAD station in the China Earthquake Networks Center observational bulletins during 1 June to 20 September 2021, and manually pick P and S wave arrival times from high-quality seismograms recorded at 34 recently deployed MaduoArray portable seismic stations. Using these arrival times, we relocate the Maduo earthquake sequence using earthquake association, absolute location and relative location methods. Our results show that the 2021 Maduo earthquake sequence occurred along the Kunlun Mountain Pass-Jiangcuo fault zone in the NWW-SEE direction and the aftershocks are located on both sides of the mainshock, showing characteristics of bilateral rupture. Vertical cross-sections of the aftershock distribution illustrate a nearly vertical shape of the seismogenic fault that tilts toward the northeast and southwest in different sections, reflecting a complex geometry of the fault plane. There is a horsetail bifurcation phenomenon at the eastern end of the fault zone. A sparse area of aftershocks appears at about 30 km east of the mainshock epicenter, which may be associated with a uniform fault friction and sufficient release of rupture energy caused by super-shear rupture of the mainshock. Taking into account many geophysical results including seismic tomography and magnetotelluric soundings, we speculate that the occurrence of the Maduo earthquake could be affected by crustal fluids in the fault zone. The fluids may ascend from the lower crustal flow beneath northeastern Tibet.

CASE REPORTS: Bilateral anterior lens capsule ruptures in Alport syndrome: case series and literature review

We present 3 cases of bilateral anterior lens capsule rupture, all leading to a subsequent diagnosis of Alport syndrome. Clinicians should be alert to the ocular and systemic features of Alport syndrome, especially when presented with a spontaneous rupture of the anterior lens capsule in young males. Ophthalmologists are often the first contact for patients with Alport syndrome, and a sound knowledge of the associated features will enable timely referral to other members of a multidisciplinary team required to treat such patients. Diagnosis and subsequent testing of affected families further aids in genetic counseling and early, comprehensive treatment.

Asymmetric Bilateral Rupture of the 2021 Mw 7.4 Maduo Earthquake in China and Association with Seismogenic Fault Structures

Asymmetric Bilateral Rupture of the 2021 Mw 7.4 Maduo Earthquake in China and Association with Seismogenic Fault Structures

Comparison of erectile and ejaculatory functional outcomes between unilateral and bilateral cavernosal rupture in penile fractures

This study aimed to compare the erectile and ejaculatory functional outcomes of unilateral and bilateral ruptures of the corpus cavernosum in penile fractures. Sixty patients’ data were analyzed retrospectively between June 2020 and January 2023. The patients were divided into two groups based on the affected corpus cavernosum (unilateral and bilateral). Preoperative and postoperative 3rd-, 6th-, and 12th-month self-estimated intravaginal-ejaculation-latency-time (IELT), and international index of erectile function-erectile function (IIEF-EF) scores as well as the presence of urethral injury were compared. Bilateral corpus cavernosum fractures were detected in 18.3% of the patients. The IIEF-EF scores of both groups at 3rd-, 6th-, and 12th-month were found to be significantly lower than the preoperative scores (unilateral group:24.1 ± 2.7 vs 23.2 ± 3.5 and 23.3 ± 3.4, respectively, p = 0.011 and 0.014, respectively; bilateral group: 24 ± 1.9 vs 23 ± 1.8 and 23.2 ± 1.5, respectively, p = 0.027 and 0.047, respectively). No significant difference was found between the preoperative and the postoperative 12th month IIEF-EF scores in either group (unilateral group: 24.1 ± 2.7 vs 23.4 ± 3.6, p = 0.207;bilateral group:24 ± 1.9 vs 23.2 ± 1.5, p = 0.057). The self-estimated IELTs of both groups at the postoperative 3rd, 6th, and 12th months demonstrated a significant increase from the preoperative values (unilateral group: 221.6 ± 81.8 vs 252 ± 94.6, 256.5 ± 97.6, and 250.5 ± 104.8, respectively, p < 0.001; bilateral group:241.8 ± 61.6 vs 278.1 ± 55.4, 281.8 ± 56.1, and 283.6 ± 54.2, respectively, p = 0.041, 0.030, and 0.047, respectively). The changes in self-estimated IELTs and IIEF-EF scores between the preoperative period and the postoperative 3rd, 6th, and 12th-months were compared, and no statistical difference was found between patients with unilateral and bilateral corpus cavernosum fractures (p > 0.05). In conclusion, no significant difference in erectile function was found in either group at the 12-month follow-up, and the self-estimated IELTs were found to be prolonged in both groups. Furthermore, no difference was noted between the groups at any follow-up. To explain the effects of unilateral and bilateral injuries on erectile and ejaculatory functions, further studies with a larger-number of patients are necessary.

Complete transection of the bilateral main bronchus in a 5-year-old patient: a case report

BackgroundTracheobronchial injuries caused by blunt chest trauma are rare in children, and such injuries usually involve multiple organs. Most cases involve respiratory failure on the way to the hospital, and the mortality rate is high. Herein, we describe the case of a 5-year-old patient who fell from an electric vehicle, causing complete rupture of the bilateral main bronchus.Case presentationWe treated a 5-year-old patient with complete bilateral main bronchus rupture. Chest computed tomography (CT) failed to detect bronchial rupture. Continuous closed thoracic drainage resulted in a large amount of bubble overflow. Tracheal rupture was suspected. Fibreoptic bronchoscopy revealed complete rupture of the right main bronchus and rupture of the left main bronchus. Emergency tracheoplasty was performed under cardiopulmonary bypass (CPB). During the operation, we found that the bilateral main bronchi were completely ruptured. Postoperative recovery was smooth. The traditional surgical method for treating these injuries is lateral thoracotomy. However, a median sternotomy provides a better opportunity for selective repair. Extracorporeal circulation-assisted surgery is required for patients with unstable breathing.ConclusionComplete fractures of the bilateral main bronchi are rare. Bronchial rupture should be suspected in the presence of expansion defect-dropped lungs and massive air leakage despite tube thoracostomy in haemopneumothorax developing after thoracic trauma. Extracorporeal circulation-assisted tracheoplasty is a relatively safe option for children whose respiratory system is difficult to maintain, thus ensuring oxygenation ventilation and a clear surgical field.

Retrospective performance analysis of a ground shaking early warning system for the 2023 Turkey–Syria earthquake

Recently developed earthquake early warning systems rely on the idea of combining the measured ground motion and the source parameter estimate to issue an alert based on the ground shaking prediction at sites where high potential damage is expected. Here we apply a P-wave, shaking-forecast method that can track and alert in real-time the area where peak ground motion is expected to exceed a user-set threshold during the earthquake. The system performance in providing a fast and reliable warning during the Mw 7.8, February 6 Turkey–Syria earthquake is investigated by the real-time simulated playback of the near-source hundred accelerograms. With an instrumental intensity threshold IMM=IV\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${I}_{{MM}}={IV}$$\\end{document} an alert issued 10–20 s after the event origin, results in 95% of successful warning (positive and negative) and lead-times of 10–60 s within the potential damage zone. Setting a higher intensity threshold requires larger alert times (50–60 s) to achieve 90% of successful warning and overall shorter lead-times. Our simulation shows that the P-wave predicted, strong-shaking zone can be rapidly detected only 20 s after the mainshock nucleation. As the time increases, it well delineates the NE-SW bi-lateral rupture development as inferred by kinematic source models.

Spontaneous Rupture of the Knee Extensor Apparatus in a Chronic Renal Failure Patient: A Case Report

This summary discusses the rare occurrence of non-traumatic bilateral rupture of the knee extensor apparatus. This pathology involves spontaneous rupture of the quadriceps et patellar tendons in both knees without a history of recent trauma. Non-traumatic tendon ruptures, particularly bilateral cases, are uncommon and may be associated with underlying systemic or metabolic conditions such as diabetes or renal failure, which can contribute to tendon fragility. Management typically involves surgical repair of the ruptured tendons followed by intensive rehabilitation to restore knee function and strength. Close monitoring is essential to identify potential complications and optimize long-term outcomes.

Bilateral simultaneous distal biceps tendon rupture repair with both cortical button and interference screw

Bilateral simultaneous distal biceps tendon rupture repair with both cortical button and interference screw

Along-Strike Variation of Rupture Characteristics and Aftershock Patterns of the 2023 Mw 7.8 Türkiye Earthquake Controlled by Fault Structure

Abstract On 6 February 2023, an Mw 7.8 earthquake occurred along the East Anatolian fault zone (EAFZ) in southeastern Türkiye, representing the strongest earthquake in the region in nearly 80 yr. We investigate rupture characteristics and aftershock patterns of the earthquake through focal mechanism calculation, backprojection analysis, and finite-fault inversion. The results show bilateral rupture propagation of the mainshock with transient supershear speed in the southwest portion of the EAFZ, as well as shallower coseismic slip and abundant normal-faulting aftershocks in the same portion. We attribute these earthquake behaviors to the along-strike variation of fault structure of the EAFZ, which features a more complex fault geometry accompanied by numerous short normal faults in the southwest portion. These results shed light on fault segmentation, rupture speed variation, and slip partitioning along the EAFZ, advancing our understanding of fault structural control on earthquake behaviors in a complex multisegment fault system.

Traumatic Bilateral Quadriceps Tendon Rupture from a Ground Level Fall

This is a clincal image submission depicting traumatic bilateral quadriceps tendon rupture from a ground level fall.

Variability in Outcome After Bilateral, Fluoroquinolones-Associated Achilles Tendon Rupture: A Case Report

BACKGROUND: Achilles tendon rupture can be debilitating, and there is substantial variability in outcomes after Achilles tendon rupture. Patient- and tissue-level characteristics are beginning to emerge as healing indicators with the potential of identifying impaired healing earlier in recovery. CASE PRESENTATION: Patient with fluoroquinolone-induced, bilateral Achilles tendon rupture managed nonoperatively. OUTCOME AND FOLLOW-UP: Tendon tissue level outcomes on ultrasound, strength, range of motion, and patient-reported outcomes are reported. With similar treatment of bilateral tendons, the patient achieved good healing outcomes (evidenced by limited tendon elongation and walking capacity) on one side but had limited healing (evidenced by tendon retraction and need for bracing with walking) on the other side. DISCUSSION: The findings from this case report highlight the variability of patient outcomes after Achilles tendon rupture, even when treatment and the systemic healing environment is similar. This report also demonstrates the potential clinical utility of routine ultrasound imaging to assess early tendon healing before strength and other functional outcomes can be assessed. JOSPT Cases 2024;4(1):12-18. Epub 13 November 2023. doi:10.2519/josptcases.2023.12109

Case report: Nonsimultaneous bilateral triceps tendon rupture and surgical repair in a healthy dog

A 7-year-old female spayed Australian shepherd dog was presented for an acute onset of inability to stand. On physical examination, the dog was unable to support weight on the thoracic limbs. On neurological examination, the thoracic limbs had absent hopping and paw placement and reduced withdrawal reflexes bilaterally. The remainder of the neurological examination was normal. The anatomic lesion localized to the C6-T2 spinal nerve roots, spinal nerves, or the named nerves of the thoracic limb, bilaterally. A lesion affecting the ventral gray column of the C6 through T2 spinal cord segments was considered less likely. In an effort to exclude an orthopedic disorder from consideration, radiographs of the shoulders, elbows, and manus were normal. Magnetic resonance imaging of the cervical and cranial thoracic vertebral column was normal. Analysis of synovial fluid from the carpi, elbows, and shoulders were normal. Ultrasonography of the triceps muscle and tendon of insertion revealed bilateral, acute-subacute tears of the tendon at insertion of the triceps muscles, bilaterally. Magnetic resonance imaging of both elbows revealed complete avulsion of the triceps tendons bilaterally. Surgical repair of both tendons was performed using the Arthrex FiberLoop system combined with autologous conditioned plasma soaked in a collagen sponge. Postoperatively, external coaptation was provided using Spica splints for 6 weeks followed by the use of soft padded orthotic braces for an additional 6 weeks. Concurrently, a front support wheelchair was used for 10 weeks postoperative. By 10 weeks postoperative, the dog was able to ambulate without support. To the authors’ knowledge, this is the first report of bilateral triceps tendon avulsion in a dog. Tendon avulsion occurred without a known history of trauma or predisposing metabolic abnormalities. Magnetic resonance imaging provided excellent anatomical detail that aided in surgical repair.

Supershear triggering and cascading fault ruptures of the 2023 Kahramanmaraş, Türkiye, earthquake doublet.

On 6 February 2023, two large earthquakes (moment magnitude 7.8 and 7.6) shocked a vast area of southeastern Türkiye and northern Syria, leading to heavy casualties and economic loss. To investigate the rupture process over multiple fault segments, we performed a comprehensive analysis of local seismic and geodetic data and determined supershear ruptures on the initial branch and the Pazarcık and Erkenek segments and subshear ruptures on the Amanos segment of event 1. The bilateral rupture of event 2 also presents distinct sub- and supershear velocities. The dynamic stress of the branch fault rupture triggered the Pazarcık segment initial rupture at a point 9 kilometers west of the junction of these two faults, boosting the supershear rupture of the Pazarcık segment of the main fault. The geometry and prestress level of multiple segments controlled the rupture behaviors and influenced the ground shaking intensity.

Bilateral Spontaneous Rupture of the Achilles Tendon as an Initial Presentation of Alkaptonuria: A Case Report

Bilateral Spontaneous Rupture of the Achilles Tendon as an Initial Presentation of Alkaptonuria: A Case Report