Surgical technique for repair of acute proximal hamstring tears - 30/03/13

Doi : 10.1016/j.otsr.2012.05.006

N. Lefevre ^a,^b,^⁎ , Y. Bohu ^a,^b, S. Klouche ^a, S. Herman ^a,^b
^a Clinique du sport Paris V, 36, boulevard Saint-Marcel, 75005 Paris, France
^b Institut Nollet, 23, rue Brochant, 75017 Paris, France

Corresponding author. Paris V Sports Surgical Institute, 36, boulevard Saint-Marcel, 75005 Paris, France. Tel.: +33 1 40 79 40 36; fax: +33 1 40 79 40 43.

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Summary

The surgical technique for repair of acute proximal hamstring tears is relatively recent. Installation of the patient is critical. The approach is either vertical under the gluteal fold in case of a complete tear with tendon retraction of more than 6cm, or horizontal in the gluteal fold for retraction of less than 6cm or for partial tears. After identification and neurolysis of the sciatic nerve, transosseous tendon reinsertion is performed with three or four metal or resorbable suture anchors. A rigid brace keeping the leg at 30° of flexion is worn for few days, then replaced by an articulated knee brace for 45 days, which limits extension but allows full flexion. Rehabilitation is begun early. Thirty-four patients underwent surgery for acute proximal hamstring tear and received this treatment. All of the athletic patients were able to return to their pre-injury activities after a mean 5.7±1.6 months (2.3-9.3 months).

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Keywords : Acute proximal hamstring tear, Surgical repair, Activity level, Return-to-sport