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腘绳肌复合体部分断裂:治疗选择的文献综述

Partial rupture of the hamstring muscle complex: a literature review on treatment options.

作者信息

Horst Klemens, Dienstknecht T, Sellei R M, Pape H C

出版信息

Eur J Orthop Surg Traumatol. 2014 Apr;24(3):285-9. doi: 10.1007/s00590-013-1315-x.

Abstract

Injuries of the hamstring muscle complex (HMC) often affect athletes participating in specific sporting activities. Mild injuries that constitute a mere strain of the muscle can be managed symptomatically, while severe injuries often require surgical intervention to precipitate a return to function. Neglected injuries usually result in a long-term functional impairment. Therefore, surgical reconstruction of the HMC is advised for both partial and complete lesions. Without acute repair, a chronic lesion referred to as hamstring syndrome can result due to dysfunction of the HMC. Surgical intervention is usually recommended. A case of a chronic severe partial injury to the HMC managed conservatively in a 49-year old female is presented to illustrate the level of function that can be achieved after non-operative management. The clinical and radiological findings are presented 18 months post-injury along with a review of the current literature. There are no previous reports in the literature describing this scenario. This case indicates the need for re-evaluation in treatment options in partial hamstring muscle ruptures. A surgical treatment of partial rupture should be considered more often as an adequate treatment option and cofactors that influence the prognosis must be revealed. The indication of surgical intervention should be re-evaluated within the first months in case of conservative treatment.

摘要

腘绳肌复合体(HMC)损伤常影响参与特定体育活动的运动员。仅为肌肉拉伤的轻度损伤可进行对症处理,而严重损伤往往需要手术干预才能恢复功能。被忽视的损伤通常会导致长期功能障碍。因此,对于部分和完全损伤,建议对HMC进行手术重建。若不进行急性修复,HMC功能障碍可能导致一种称为腘绳肌综合征的慢性损伤。通常建议进行手术干预。本文介绍了一名49岁女性HMC慢性严重部分损伤采用保守治疗的病例,以说明非手术治疗后可达到的功能水平。在受伤18个月后展示了临床和放射学检查结果,并对当前文献进行了综述。文献中此前没有描述这种情况的报告。该病例表明,对于部分腘绳肌断裂的治疗方案需要重新评估。部分断裂的手术治疗应更常被视为一种合适的治疗选择,且必须揭示影响预后的辅助因素。若采用保守治疗,应在最初几个月内重新评估手术干预的指征。

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