Ernlund Lucio, Vieira Lucas de Almeida
Instituto de Joelho e Ombro, Curitiba, PR, Brazil.
Rev Bras Ortop. 2017 Aug 1;52(4):373-382. doi: 10.1016/j.rboe.2017.05.005. eCollection 2017 Jun-Jul.
Hamstring (HS) muscle injuries are the most common injury in sports. They are correlated to long rehabilitations and have a great tendency to recur. The HS consist of the long head of the biceps femoris, semitendinosus, and semimembranosus. The patient's clinical presentation depends on the characteristics of the lesion, which may vary from strain to avulsions of the proximal insertion. The most recognized risk factor is a previous injury. Magnetic resonance imaging is the method of choice for the injury diagnosis and classification. Many classification systems have been proposed; the current classifications aim to describe the injury and correlate it to the prognosis. The treatment is conservative, with the use of anti-inflammatory drugs in the acute phase followed by a muscle rehabilitation program. Proximal avulsions have shown better results with surgical repair. When the patient is pain free, shows recovery of strength and muscle flexibility, and can perform the sport's movements, he/she is able to return to play. Prevention programs based on eccentric strengthening of the muscles have been indicated both to prevent the initial injury as well as preventing recurrence.
腘绳肌(HS)损伤是体育运动中最常见的损伤。它们与长时间的康复相关,并且有很高的复发倾向。腘绳肌由股二头肌长头、半腱肌和半膜肌组成。患者的临床表现取决于损伤的特征,损伤特征可能从拉伤到近端附着点撕脱不等。最公认的风险因素是既往损伤。磁共振成像(MRI)是损伤诊断和分类的首选方法。已经提出了许多分类系统;目前的分类旨在描述损伤并将其与预后相关联。治疗是保守的,在急性期使用抗炎药物,随后进行肌肉康复计划。近端撕脱伤通过手术修复显示出更好的效果。当患者无痛、力量和肌肉柔韧性恢复且能够进行运动动作时,他/她就能够重返比赛。基于肌肉离心强化的预防计划已被证明既能预防初始损伤,又能预防复发。