Clin Orthop Surg.  2011 Sep;3(3):249-253. 10.4055/cios.2011.3.3.249.

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

• Kwak HY
• Bae SW
• Choi YS
• Jang MS

• KMID: 1743917
• DOI: http://doi.org/10.4055/cios.2011.3.3.249

Abstract

Hamstring injuries are common forms of muscle strains in athletes but a complete rupture of a proximal hamstring origin is rare. Often there is a considerable delay in diagnosis and stringent treatment because of its rarity, difficulty in clinical diagnosis, and initial attempts of conservative care. We report two cases of acute complete rupture of the proximal hamstring tendons treated with early surgical repair. The diagnosis and treatment of this unusual injury are discussed.

Keyword

Proximal hamstring; Complete rupture; Surgical repair

MeSH Terms

Acute Disease
Adolescent
Adult
Football/*injuries
Humans
Male
Martial Arts/*injuries
Rupture
Tendon Injuries/diagnosis/*surgery
Thigh
Young Adult

Figure

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  Fig. 1 Swelling and ecchymosis over the posterior aspect of the right proximal thigh.

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  Fig. 2 Case 1. (A) Axial proton and (B) coronal proton fast spin echo magnetic resonance (MR) images of the right thigh show complete detachment of the semimembranosus tendon (long arrows) and the conjoined biceps femoris-semitendinosus tendon (short arrows) from the ischial tuberosity. (C) More posteriorly, the coronal inversion recovery MR image shows retraction of the common hamstring tendon (black arrows). The associated muscle shows high signal intensity on proton and inversion-recovery MR images, which is indicative of edema or hemorrhage.

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  Fig. 3 (A) Intraoperative view shows complete rupture of the proximal hamstring complex and a single tendon comprising all three tendons. (B) The injured tendons were reattached to the exposed ischium under sufficient tension. (C) Postoperative pelvis oblique radiograph shows three suture anchors (arrow) that are well located in the right ischial tuberosity.

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  Fig. 4 Case 2. (A) Coronal proton and (B) axial proton fast spin echo magnetic resonance (MR) images of the left thigh show high signal intensity of the hamstring origins (arrows) with a complete tear. Note the low signal intensity of the contralateral hamstring origins on the coronal proton MR image (A).

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