职业足球运动员的腿后肌损伤：与重返赛场的磁共振成像相关性。
Hamstring injuries in professional football players: magnetic resonance imaging correlation with return to play.
机构信息
Rothman Institute / Thomas Jefferson University, Philadelphia, Pennsylvania.
出版信息
Sports Health. 2011 Sep;3(5):423-30. doi: 10.1177/1941738111403107.
BACKGROUND
Magnetic resonance imaging (MRI) allows for detailed evaluation of hamstring injuries; however, there is no classification that allows prediction of return to play.
PURPOSE
To correlate time for return to play in professional football players with MRI findings after acute hamstring strains and to create an MRI scoring scale predictive of return to sports.
STUDY DESIGN
Descriptive epidemiologic study.
METHODS
Thirty-eight professional football players (43 cases) sustained acute hamstring strains with MRI evaluation. Records were retrospectively reviewed, and MRIs were evaluated by 2 musculoskeletal radiologists, graded with a traditional radiologic grade, and scored with a new MRI score. Results were correlated with games missed.
RESULTS
Players missed 2.6 ± 3.1 games. Based on MRI, the hamstring injury involved the biceps femoris long head in 34 cases and the proximal and distal hamstrings in 25 and 22 cases, respectively. When < 50% of the muscle was involved, the average number of games missed was 1.8; if > 75%, then 3.2. Ten players had retraction, missing 5.5 games. By MRI, grade I injuries yielded an average of 1.1 missed games; grade II, 1.7; and grade III, 6.4. Players who missed 0 or 1 game had an MRI score of 8.2; 2 or 3 games, 11.1; and 4 or more games, 13.9.
CONCLUSIONS
Rapid return to play (< 1 week) occurred with isolated long head of biceps femoris injures with < 50% of involvement and minimal perimuscular edema, correlating to grade I radiologic strain (MRI score < 10). Prolonged recovery (missing > 2 or 3 games) occurs with multiple muscle injury, injuries distal to musculotendinous junction, short head of biceps injury, > 75% involvement, retraction, circumferential edema, and grade III radiologic strain (MRI score > 15).
CLINICAL RELEVANCE
MRI grade and this new MRI score are useful in determining severity of injury and games missed-and, ideally, predicting time missed from sports.
背景
磁共振成像（MRI）可对腘绳肌损伤进行详细评估；然而，目前尚无能够预测运动员重返赛场的分类方法。
目的
探讨职业足球运动员急性腘绳肌拉伤后 MRI 检查结果与重返赛场时间的相关性，并建立一种预测重返运动的 MRI 评分系统。
研究设计
描述性流行病学研究。
方法
38 名职业足球运动员（43 例）发生急性腘绳肌拉伤，进行 MRI 评估。回顾性分析病历，由 2 名肌肉骨骼放射科医生对 MRI 进行评估，采用传统放射学分级进行分级，并采用新的 MRI 评分进行评分。将结果与错过的比赛相关联。
结果
运动员平均缺席 2.6±3.1 场比赛。根据 MRI 结果，34 例患者的半腱肌和半膜肌长头受累，25 例和 22 例患者近端和远端腘绳肌受累。当肌肉受累<50%时，平均缺席比赛 1.8 场；如果>75%，则缺席 3.2 场。10 名患者有回缩，平均缺席 5.5 场比赛。I 级损伤的运动员平均缺席 1.1 场比赛；II 级损伤为 1.7 场；III 级损伤为 6.4 场。0 或 1 场比赛的运动员 MRI 评分为 8.2；2 或 3 场比赛为 11.1；4 或更多场比赛为 13.9。
结论
快速重返赛场（<1 周）发生于孤立的长头半腱肌损伤且累及<50%，伴有最小的肌周水肿，与 I 级放射学应变（MRI 评分<10）相关。延长恢复期（错过 2 或 3 场以上比赛）与多肌肉损伤、肌腱肌腹交界处远端损伤、短头半腱肌损伤、>75%受累、回缩、环状水肿和 III 级放射学应变（MRI 评分>15）相关。
临床相关性
MRI 分级和新的 MRI 评分有助于确定损伤严重程度和错过的比赛次数，并能理想地预测运动员重返运动的时间。
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