Shyamalan G, Bircher M
St. Georges Hospital NHS Trust, London SW190QT, United Kingdom.
Injury. 2010 Aug;41(8):823-6. doi: 10.1016/j.injury.2010.03.022. Epub 2010 May 26.
Proximal hamstring injury represents a spectrum of trauma to either the bone or the soft tissues. Injuries can be complete or incomplete. Complete injuries usually require surgical treatment.We discuss the operative management of eight consecutive cases of chronic complete proximal hamstring injuries (injury to surgery >2.5 months). Of the eight patients, three patients had soft tissue avulsions, which were reattached with anchors via a longitudinal buttock crease incision. Five patients had bony avulsions requiring open reduction and internal fixation. In three of these, the retraction of the fragment into the thigh was so great that it was not easily retrievable and fixable through a conventional approach. On the basis of a cadaveric study, a double-window surgical approach was developed to enable us to treat these avulsions with extreme retraction. This approach can be used for other less severe injuries.
腘绳肌近端损伤是指骨骼或软组织受到的一系列创伤。损伤可分为完全性或不完全性。完全性损伤通常需要手术治疗。我们讨论了连续8例慢性完全性腘绳肌近端损伤（受伤至手术时间>2.5个月）的手术治疗。8例患者中，3例为软组织撕脱伤，通过纵向臀部皱襞切口用锚钉重新固定。5例为骨撕脱伤，需要切开复位内固定。其中3例，骨折块向大腿内回缩严重，通过传统方法难以复位和固定。基于尸体研究，我们开发了一种双窗口手术方法，使我们能够治疗这些严重回缩的撕脱伤。该方法也可用于其他不太严重的损伤。
