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Avulsion of the proximal hamstring origin. Surgical technique
James Carmichael1, Iain Packham, S Paul Trikha
1North Sydney Orthopaedic and Sports Medicine Centre, Crows Nest, Sydney, NSW, Australia.
The Journal of Bone and Joint Surgery. American Volume
|October 7, 2009
Summary
Surgical repair of proximal hamstring origin avulsions yields satisfactory results. Early surgical intervention is recommended for complete avulsions to improve outcomes and avoid complications.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Reconstructive Surgery
Background:
- Proximal hamstring origin avulsions are common athletic injuries.
- Surgical repair is a treatment option for these injuries.
- Understanding clinical presentation, imaging, surgical techniques, and outcomes is crucial.
Purpose of the Study:
- To review the clinical presentation of proximal hamstring origin avulsions.
- To analyze diagnostic imaging findings.
- To describe surgical reattachment techniques and clinical outcomes.
Main Methods:
- Seventy-two reconstructions in seventy-one patients were analyzed.
- Mean patient age was 40.2 years.
- Mean follow-up was 24 months, with all patients having at least 6 months follow-up.
Main Results:
- Waterskiing was the most frequent cause (21 cases).
- Complete avulsion was the most common finding (87.5%), with a mean retraction of 7 cm.
- Postoperative hamstring strength averaged 84% and endurance 89% of the contralateral side.
Conclusions:
- Distinguish avulsions from muscle injuries; recommend early surgical repair for avulsions.
- Delayed repair increases technical difficulty, risk of sciatic nerve involvement, and need for bracing.
- Surgical treatment for hamstring origin avulsions provides predictable and satisfactory results.
