Complete Proximal Hamstring Avulsions

Abstract

Excellent or good results can often be expected with surgery, and considerable improvement of symptoms may be achieved even in chronic cases. According to the results, early operative treatment in complete proximal avulsions of the hamstring muscles gives better results than does late surgery and is therefore recommended.

Early Surgical Repair of Acute Complete Rupture of the Proximal Hamstring Tendons

“…Often there is a considerable delay in diagnosis because of its rarity, difficulty in clinical diagnosis by deep seating of the injured tendons beneath the thick layer of adipose tissue and the belly of the gluteus maximus muscle, initial attempt of conservative care, and under-appreciation of the residual loss of function in non-surgically treated cases. MRI is essential for a correct diagnosis in cases where a tear is suspected 3,5,7-9…”

“…They suggested early repair for active patients to allow easier repair and an early return to function. Sarimo et al5) reported the surgical treatment of complete proximal hamstring tendon ruptures in 41 patients. When the patients were divided into 3 groups (0-3 months, 3-6 months, and > 6 months) according to the delay from injury to surgery, there were significant diff erences in the result.…”

“…The authors recommended early surgical repair using a bone-anchor-suture-tendon system and protective bracing for post-operative 6 weeks in both acute and chronic cases. In 2008, two reports of a larger series of proximal hamstring ruptures were published by Sarimo et al5) (14 acute and 27 chronic case) and Folsom and Larson6) (21 acute and 5 chronic cases), who concluded that acute surgical repair of proximal hamstring ruptures is easier to perform, provides better results and high return to the preinjury activity level than late surgery and is therefore recommended. The present paper reports two cases of acute complete rupture of the proximal hamstring tendons that were treated successfully with early surgical repair.…”

Two patients with a complete proximal rupture of the hamstring

“…In general, results of operative treatment are better in the acute stadium, i.e., within 4 weeks after trauma, than older ruptures [4–7, 9–12]. At a longer existing rupture, there is retraction of the muscle stump.…”

“…Patients could practice their sports in most cases at pre-injury level 6–12 months after operation [4–7, 9, 10, 12, 16]. In contrary were the results of conservative-treated patients [8].…”