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[腘绳肌腱近端断裂:从临床表现到诊断与治疗]

[Proximal rupture of the hamstring tendon : From clinical presentation to diagnosis and therapy].

作者信息

Bauer S, Riegger M, Friedrich K J, Reichert W, Blakeney W G, Haag C

机构信息

Schulter-, Sport- und arthroskopische Chirurgie, Klinik für Unfallchirurgie, Kreiskrankenhaus Lörrach, Spitalstr. 25, 79539, Lörrach, Deutschland.

出版信息

Unfallchirurg. 2016 Dec;119(12):1031-1042. doi: 10.1007/s00113-016-0277-y.

Abstract

Rupture of the proximal tendon enthesis of the hamstring muscle (ICM) accounts for approximately 10% of all injuries of the ICM. It occurs most commonly in athletes and active middle-aged individuals. The complete rupture of all three tendons in active patients is generally seen as an indication for surgical repair of the tendon enthesis; however, the correct diagnosis is often not reached in a timely manner. This can lead to prolonged symptoms with pain, weakness and neuralgia. Operative treatment consists of anchor repair of the tendons resulting in good clinical outcome in several case series. Good knowledge of the anatomy and operative approach are mandatory to avoid complications as well as compliance with a gradual rehabilitation scheme to allow tendon to bone healing. The main aim of this review is to highlight the typical history, clinical presentation and examination technique to reach an immediate clinical diagnosis which should be confirmed with a magnetic resonance imaging (MRI) scan.

摘要

腘绳肌近端肌腱附着点断裂(ICM)约占ICM所有损伤的10%。它最常见于运动员和活跃的中年个体。活跃患者中所有三条肌腱的完全断裂通常被视为肌腱附着点手术修复的指征;然而,正确的诊断往往不能及时做出。这可能导致疼痛、无力和神经痛等症状持续时间延长。手术治疗包括肌腱锚定修复,在多个病例系列中取得了良好的临床效果。必须充分了解解剖结构和手术入路以避免并发症,并遵循逐步康复方案以促进肌腱至骨的愈合。本综述的主要目的是强调典型病史、临床表现和检查技术,以实现即时临床诊断,该诊断应通过磁共振成像(MRI)扫描加以证实。

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