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Related Concept Videos

Muscles that Move the Leg01:23

Muscles that Move the Leg

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The movement of the legs is facilitated by numerous muscles located within the anterior, medial, and posterior compartments of the thigh.
Anterior Compartment
The quadriceps femoris, the most visible muscle of the anterior compartment, is integral for leg extension and thigh flexion. It is formed by merging four distinct muscles — the vastus lateralis, vastus medialis, vastus intermedius, and rectus femoris. The quadriceps tendon, a shared tendon of the four quadriceps muscles, is affixed...
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Sciatic Nerve Injury After Proximal Hamstring Avulsion and Repair.

Thomas J Wilson1, Robert J Spinner1, Rohith Mohan2

  • 1Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.

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|August 1, 2017
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Summary

Proximal hamstring avulsion can cause sciatic nerve symptoms. Surgery often improves these neurologic deficits, suggesting they should be considered in treatment decisions.

Keywords:
hamstringhamstring avulsionhamstring repairsciatic nerve

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Area of Science:

  • Orthopedic Surgery
  • Neurology
  • Sports Medicine

Background:

  • The sciatic nerve is closely associated with hamstring muscles, increasing risk of injury during proximal hamstring avulsion.
  • Limited data exists on the risk, contributing factors, and outcomes of sciatic nerve injury after proximal hamstring avulsion surgery.

Purpose of the Study:

  • To determine the incidence and characteristics of sciatic nerve injury and related symptoms following proximal hamstring avulsion.
  • To evaluate the impact of surgical intervention on these neurologic symptoms.

Main Methods:

  • Retrospective review of 162 patients with proximal hamstring avulsion (67 operative, 95 nonoperative).
  • Assessed neurologic symptoms in the sciatic nerve distribution below the knee.
  • Compared pre- and postoperative neurologic symptoms in surgically treated patients.

Main Results:

  • 45 patients (27.8%) experienced sciatic nerve-related symptoms (motor deficits, sensory deficits, neuropathic pain).
  • Surgery led to significant improvement in motor deficits (100%), sensory symptoms (75%), and pain (89.5%).
  • Postoperative new or worsening deficits occurred in 7.5% of operative patients.

Conclusions:

  • Sciatic nerve symptoms post-proximal hamstring avulsion are frequently underrecognized.
  • Current decision-making for surgery does not typically account for neurologic symptoms.
  • Given the positive surgical outcomes, neurologic symptoms should be a key consideration for operative treatment decisions.