Proximal Hamstring Injuries - 03/03/21

Doi : 10.1016/j.csm.2021.01.003

Amanda N. Fletcher, MD, MS ^a, Jonathan W. Cheah, MD ^b, Shane J. Nho, MD, MS ^c, Richard C. Mather, MD, MBA ^d,^⁎
^a Department of Orthopaedic Surgery, Duke University Medical Center, 311 Trent Drive, Durham, NC 27710, USA
^b Department of Orthopaedic Surgery, Santa Clara Valley Medical Center, 751 South Bascom Avenue, San Jose, CA 95128, USA
^c Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush, 1611 West Harrison Street, Orthopedic Building Suite 400, Chicago, IL 60612, USA
^d Department of Orthopaedic Surgery, Duke University Medical Center, Duke Sports Science Institute, 3475 Erwin Road, Durham, NC 27705, USA

^∗Corresponding author.

Résumé

Proximal hamstring injuries can present as chronic tendinosis, acute strain, partial tendinous avulsions, or complete 3-tendon rupture. Nonoperative management for chronic insertional tendinosis and low-grade tears includes activity modification, anti-inflammatories, and physical therapy. Platelet-rich plasma injections, corticosteroid injections, dry needling, and shock wave therapy are newer therapies that also may provide benefit. Surgical indications include complete, proximal avulsions; partial avulsions with least 2 tendons injured with more than 2 cm of retraction in young, active patients; and partial avulsion injuries or chronic tendinosis that have failed nonoperative management. Surgical management entails open primary repair, endoscopic primary repair, or augmentation/reconstruction.

Le texte complet de cet article est disponible en PDF.

Keywords : Hamstring, Injury, Proximal hamstring injuries, Tendinosis, Tendinopathy, Strain, Rupture, Chronic insertional tendinosis