Department of Orthopaedics, University of Maryland School of Medicine, 100 Penn St, AHB, Rm 540, Baltimore, MD 21201, USA.
Clin Orthop Relat Res. 2011 Nov;469(11):3248-52. doi: 10.1007/s11999-011-2027-3. Epub 2011 Aug 18.
Muscle strains are one of the most common complaints treated by physicians. High-force lengthening contractions can produce very high forces resulting in pain and tissue damage; such strains are the most common cause of muscle injuries. The hamstring muscles are particularly susceptible as they cross two joints and regularly perform lengthening contractions during running. We describe a patient with return to full function after a large hamstring tear.
We report the case of a 26-year-old man who presented 1 year after a noncontact, left-sided proximal hamstring tear incurred while sprinting. He received no medical treatment or formal rehabilitation. He was able to return to all sports and activities 1 to 2 months after injury, but noted a persistent deformity of the proximal thigh, which led him to seek evaluation. Physical examination, MRI functional tests, and specific muscle tests 1 year after his injury documented a major hamstring tear at the musculotendinous junction with muscle retraction, but no avulsion of the proximal tendon attachment.
Surgery often is recommended for major proximal hamstring tendon tears, especially when more than one tendon of origin is ruptured from the ischial tuberosity. Myotendinous tears are treated nonoperatively, but may be associated with decreased strength, prolonged recovery, and recurrence.
We describe the case of a young man who sustained a hamstring tear, with retraction, at the proximal myotendinous junction, where the biceps femoris and semitendinosus arise from the conjoint tendon. He achieved full functional recovery without medical attention, but had a persistent cosmetic deformity and slight hamstring tightness. This case suggests a benign natural history for this injury and the appropriateness of noninvasive treatment.
肌肉拉伤是医生治疗的最常见疾病之一。高力拉长收缩会产生非常高的力，导致疼痛和组织损伤；这种拉伤是肌肉损伤的最常见原因。腘绳肌特别容易受伤，因为它们穿过两个关节，并且在跑步时经常进行拉长收缩。我们描述了一名患者在发生大的腘绳肌撕裂后恢复了全部功能。
我们报告了一名 26 岁男性的病例，他在短跑时发生了左侧非接触性近端腘绳肌撕裂，1 年前出现该情况。他未接受任何医疗或正规康复治疗。受伤后 1 至 2 个月，他能够恢复所有运动和活动，但注意到近端大腿持续畸形，这促使他寻求评估。受伤 1 年后的体格检查、MRI 功能测试和特定肌肉测试记录了在腘绳肌肌腱-肌腹交界处有一个主要的腘绳肌撕裂，伴有肌肉回缩，但坐骨结节近端肌腱附着处没有撕脱。
对于主要的近端腘绳肌腱撕裂，通常建议手术治疗，尤其是当两个以上的肌腱从坐骨结节处断裂时。对于肌-肌腱撕裂，通常采用非手术治疗，但可能与力量下降、恢复时间延长和复发有关。
我们描述了一名年轻男性的病例，他发生了在近端肌-肌腱交界处的腘绳肌撕裂，股二头肌和半腱肌从联合肌腱处起始。他没有接受医疗关注就完全恢复了功能，但有持续的美容畸形和轻微的腘绳肌紧张。该病例表明这种损伤具有良性的自然病史，并且非侵入性治疗是合适的。
