Foote Clary J, Maizlin Zeev V, Shrouder Jason, Grant Mary M, Bedi Asheesh, Ayeni Olufemi R
Departments of Orthopaedic Surgery, McMaster University Medical Centre, McMaster University, Hamilton, ON, Canada.
J Pediatr Orthop. 2013 Apr-May;33(3):227-31. doi: 10.1097/BPO.0b013e3182880978.
The aim of this study was to investigate if an association existed between the reflected head of rectus femoris avulsion injuries and labral tears in pediatric patients referred for magnetic resonance arthrography (MRA) or magnetic resonance imaging (MRI) evaluation.
Electronic medical records of the patients between the ages of 12 and 18 who were treated at the hospitals affiliated by McMaster University between June 2000 and November 2010 with a diagnosis of rectus femoris avulsion injuries were retrospectively identified and analyzed. Patients were included if they had magnetic resonance imaging or MRA images of their hip.
Nine patients with avulsion injuries of the rectus femoris muscle were identified. The patient population consisted of 4 females and 5 males (range, 8 to 17 y, mean age 14 y). All injuries occurred during sports activity, which included running and kicking during soccer, skating in hockey, and a squatting exercise. MRA examination of 7 of these patients demonstrated associated labral tears. All patients were initially treated conservatively. Five patients continued to sustain from residual pain in the 9 months after the initial injury. Two of these patients with significant refractory pain were subsequently treated with hip arthroscopy. Intraoperatively, 1 small labral tear and 1 labral avulsion were identified and treated.
This study suggests that there may be an association between avulsion of the reflected head of rectus femoris and labral injuries and that there may be an underlying spectrum of traction injuries. Patients with rectus femoris avulsion injuries with persistent symptoms may be at risk for concurrent traumatic labral tears.
Level 4, retrospective case series.
本研究旨在调查在因磁共振关节造影（MRA）或磁共振成像（MRI）评估而转诊的儿科患者中，股直肌反折头撕脱伤与盂唇撕裂之间是否存在关联。
回顾性识别并分析2000年6月至2010年11月期间在麦克马斯特大学附属医院接受治疗且诊断为股直肌撕脱伤的12至18岁患者的电子病历。若患者有髋关节的磁共振成像或MRA图像，则纳入研究。
共识别出9例股直肌撕脱伤患者。患者群体包括4名女性和5名男性（年龄范围8至17岁，平均年龄14岁）。所有损伤均发生在体育活动期间，包括足球运动中的跑步和踢球、曲棍球运动中的滑冰以及一次深蹲练习。其中7例患者的MRA检查显示存在相关的盂唇撕裂。所有患者最初均接受保守治疗。5例患者在初次受伤后的9个月内仍持续存在残留疼痛。其中2例有严重顽固性疼痛的患者随后接受了髋关节镜检查。术中，发现并处理了1例小的盂唇撕裂和1例盂唇撕脱。
本研究表明，股直肌反折头撕脱与盂唇损伤之间可能存在关联，且可能存在潜在的牵拉伤谱。有持续症状的股直肌撕脱伤患者可能并发创伤性盂唇撕裂。
4级，回顾性病例系列研究。
