Proximale Ruptur der Ischiocruralsehnen

Bauer, Stefan; Riegger, Martin; Friedrich, Kai Jochen; Reichert, W.; Blakeney, William G.; Haag, C.

doi:10.1007/s00113-016-0277-y

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…Complete ruptures of the proximal hamstring tendons result in a significant loss of strength and a functional deficit of the respective lower limb. Owing to the close anatomical proximity, irritation of the sciatic nerve could also cause neurological symptoms [4, 27, 29, 31]. Previous studies proposed inferior results after non‐surgical treatment and delayed hamstring repair and, hence, no consensus has been found regarding surgical timing [9, 22, 24, 28].…”

Section: Introductionmentioning

confidence: 99%

Excellent clinical outcome and low complication rate after proximal hamstring tendon repair at mid-term follow up

Willinger

Siebenlist

Lacheta

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose Proximal hamstring tendon avulsions lead to a significant loss of strength and a functional deficit of the respective lower limb and surgery is the recommended treatment. Only little is known about the clinical outcomes and complications when comparing acute and chronic management as well as partial and complete tears. Therefore, the purpose of this study was to investigate the clinical results and the complication rate of patients after surgical treatment of proximal hamstring tendon injuries. It was hypothesized that surgical treatment of an acute proximal hamstring avulsion would lead to a superior clinical outcome with a low complication rate and high return to sports rate compared to chronic cases and partial avulsions. Methods Patients who underwent proximal hamstring tendon repair between 2008 and 2015 were retrospectively evaluated with a minimum follow up of 2 years. Outcome measurements were obtained by means of Lysholm score, Harris Hip Score, Visual Analog Scale, and Tegner Activity Scale. Return to sports (RTS) rate was determined. Postoperative adverse events were recorded and complications reported. Patients’ outcomes were compared between acute/chronic repair and partial/complete injury patterns. Results Ninety‐four of 120 (78.3%) were available for final assessment at a mean follow‐up of 56.2 ± 27.2 months. Clinical outcome measures were excellent and did not differ between the treatment groups or between the different injury patterns. RTS was achieved by 86.2% of the patients and was significantly superior after acute treatment (p < 0.05). The overall complication rate was 8.5% and significantly higher in complete tears compared to partial tears and in delay compared to acute surgery (p < 0.05). Conclusion Surgical treatment of proximal hamstring tendon avulsions results in excellent clinical outcome scores and a high RTS rate. Open surgical treatment has shown to be a safe procedure with a low complication rate. Surgical timing is important, as early surgical intervention provides a higher RTS rate and a lower complication rate than delayed surgery and should therefore be preferred in clinical practice. Repair of partial and complete tears lead to similar clinical outcome, but a higher complication rate in complete avulsions. Level of evidence Level IV.

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Section: Introductionmentioning

confidence: 99%

Excellent clinical outcome and low complication rate after proximal hamstring tendon repair at mid-term follow up

Willinger

Siebenlist

Lacheta

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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“…Bei der operativen Versorgung sind in der Literatur zahlreiche unterschiedliche Verfahren beschrieben, die sich im Zugangsweg, dem operativen Ziel und dem verwendeten Material erheblich unterscheiden, was verdeutlicht, wie individuell und komplex die Behandlung der Avulsionsfraktur des Tuber ischiadicum ist [5,9,13,23,24]. In unserem Fall entschieden sich die Operateure für eine Längsinzision über dem Tuber ischiadicum nach distal, wie es in der Literatur bei chronischen Fällen ebenfalls empfohlen wird, um entstandene Komplikationen wie die Vernarbung des N. ischiadicus besser beheben zu können [5,14,15,27].…”

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Avulsion Fractures of the Ischial Tuberosity and Resulting Ischiofemoral Impingement – a Case Report with Literature Review

et al. 2018

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Introduction Apophyseal avulsion fractures of the ischial tuberosity are rare injuries and therefore often not diagnosed in a timely manner. Healing may then result in massive hypertrophic ischial tuberosity. This can cause ischiofemoral impingement symptoms. Due to the low incidence and scarce literature, the optimal treatment and surgery is unclear. Materials and Methods A literature search was carried out using the online medical database “PubMed”. The findings of the literature were then applied to a clinical case of delayed diagnosis of the apophyseal avulsion fracture of the ischial tuberosity. Results There is no gold standard in the literature for the treatment of avulsion fractures on the ischial tuberosity. Nearly 90% are treated conservatively and a fragment dislocation of more than 2 cm is often the indication for surgical care. However, the surgical procedures described are very diverse. An ischiofemoral impingement symptom may result from excessive ossification of the ischial tuberosity, bringing the ischiofemoral distance to the critical limit of 2 cm. Conclusions The timely correct diagnosis and initiation of a therapy is crucial for the later outcome of the patient. Ischiofemoral impingement symptoms may be the indication of bony displacement of the ischial tuberosity as a result of injury. Therapy is then surgical with partial resection of the ischial tuberosity and plate osteosynthesis.

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