Thorborg Kristian, Petersen Jesper, Nielsen Michael Bachmann, Hölmich Per
BMC Res Notes. 2013 May 22;6:205. doi: 10.1186/1756-0500-6-205.
Non-operative treatment of acute hip adductor longus ruptures in athletes has been described in the literature. However, very limited information concerning the recovery of this type of injury exists. This case represented a unique possibility to study the recovery of two acute adductor longus ruptures, using novel, reliable and validated assessment methods.
A 22-year old male soccer player (Caucasian) sustained two subsequent acute adductor longus ruptures, one in each leg. The injuries occurred 10 months apart, and were treated non-surgically in both situations. He was evaluated using hip-strength assessments, self-report and ultrasonography until complete muscle-strength recovery of the hip adductors had occurred. The player was able to participate in a full soccer training session without experiencing pain 15 weeks after the first rupture, and 12 weeks after the second rupture. Full hip adductor muscle-strength recovery was obtained 52 weeks after the first rupture and 10 weeks after the second rupture. The adductor longus injuries, as verified by initial ultrasonography (10 days post-injury), showed evidence of a complete tendon rupture in both cases, with an almost identical imaging appearance. It was only at 6 and 10 weeks ultrasonographic follow-up that the first rupture was found to include a larger anatomical area than the second rupture.
From this case we can conclude that two apparently similar hip adductor longus ruptures, verified by initial ultrasonography (10 days post-injury), can have very different hip adductor strength recovery times. Assessment of adductor strength recovery may therefore in the future be a useful and important additional measure for determining when soccer players with hip adductor longus ruptures can return safely to play.
文献中已描述了运动员急性髋内收长肌断裂的非手术治疗方法。然而,关于此类损伤恢复情况的信息非常有限。本病例提供了一个独特的机会,可使用新颖、可靠且经过验证的评估方法来研究两处急性髋内收长肌断裂的恢复情况。
一名22岁的男性足球运动员(白种人)先后出现两处急性髋内收长肌断裂,每条腿各一处。两次损伤间隔10个月,均采用非手术治疗。在髋内收肌完全恢复肌肉力量之前,对其进行了髋部力量评估、自我报告和超声检查。该运动员在第一次断裂后15周、第二次断裂后12周能够参加完整的足球训练课程且无疼痛。第一次断裂后52周、第二次断裂后10周,髋内收肌肌肉力量完全恢复。最初的超声检查(受伤后10天)证实,两处髋内收长肌损伤均显示为完全性肌腱断裂,影像学表现几乎相同。仅在超声检查随访的6周和10周时发现,第一次断裂涉及的解剖区域比第二次断裂更大。
从本病例我们可以得出结论,经最初的超声检查(受伤后10天)证实看似相似的两处髋内收长肌断裂,其髋内收肌力量恢复时间可能有很大差异。因此,未来评估内收肌力量恢复情况可能是确定髋内收长肌断裂的足球运动员何时能够安全重返赛场的一项有用且重要的额外措施。