Department for Orthopedic Sports Medicine, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Department of Orthopaedics and Trauma Surgery, Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany.
Knee Surg Sports Traumatol Arthrosc. 2020 Apr;28(4):1221-1229. doi: 10.1007/s00167-019-05717-7. Epub 2019 Sep 20.
Epidemiologic data of proximal hamstring avulsions have mainly been reported in relatively small patient cohorts. Detailed information on patient demographics, injury mechanism, and injury patterns is lacking in the literature. Since these injuries are rare and frequently misdiagnosed, a better understanding may help to increase awareness and to improve diagnosis of proximal hamstring avulsions.
A chart review was performed to identify all patients who had undergone surgical repair for complete proximal hamstring avulsions between 01/2006 and 02/2019 at the authors' institution. The following demographic and injury-specific data were obtained: Sex, age, body mass index (BMI), cause of injury (sports, activities of daily living, and others), presence of neurologic symptoms referable to the sciatic nerve, time to surgery, injury pattern (affected tendons), tendon retraction, and type of injury according to Wood et al.`s classification (Type 1: osseous avulsions, Type 2: tear at the musculotendinous junction, Type 3: incomplete avulsion from bone, Type 4: complete avulsion with only minimal retraction, and Type 5: complete avulsion with retraction > 2 cm). Data were analyzed for the entire study population and group comparison was performed with regard to sex, cause of injury, and the type of injury.
A total of 263 patients were included (53% male). The mean age was 49 ± 13 years with most patients (56%) aged between 45-59 years. Most injuries occurred while participating in sports (52%) and injury type 5 was most commonly diagnosed (66%). Five percent of patients had sensory deficits referable to the sciatic nerve. Gender comparison showed that female patients were significantly older, predominantly represented in the age group 45-59 years, and most commonly injured during activities of daily living, whereas male patients were significantly more often represented in younger age groups, and the most common cause of injury was sports. Compared to Type 4 and 5 injuries, patients with a Type 1 injury were significantly younger and had a significantly longer time to surgery.
Proximal hamstring avulsion occurs predominately in the middle-aged patient and only rarely in patients under the age of 30 years. No gender dominance exists. Female patients are typically older and get injured during activities of daily living, whereas male patients are younger and get injured more often during sports. These epidemiologic data may help physicians to make an accurate and early diagnosis.
IV.
近端腘绳肌腱撕脱伤的流行病学数据主要在相对较小的患者队列中报告。关于患者人口统计学、损伤机制和损伤模式的详细信息在文献中缺乏。由于这些损伤较为罕见且经常误诊，因此更好地了解这些损伤可能有助于提高认识并改善近端腘绳肌腱撕脱伤的诊断。
对作者机构在 2006 年 1 月至 2019 年 2 月期间接受手术修复的所有完全性近端腘绳肌腱撕脱伤患者进行图表回顾。获取以下人口统计学和损伤特异性数据：性别、年龄、体重指数（BMI）、损伤原因（运动、日常生活活动和其他）、坐骨神经可触及的神经症状、手术时间、损伤模式（受累肌腱）、肌腱回缩以及根据 Wood 等人的分类的损伤类型（1 型：骨撕脱、2 型：肌腱肌腹交界处撕裂、3 型：不完全骨撕脱、4 型：仅有轻微回缩的完全撕脱、5 型：回缩>2cm 的完全撕脱）。对整个研究人群进行数据分析，并对性别、损伤原因和损伤类型进行组间比较。
共纳入 263 例患者（53%为男性）。平均年龄为 49±13 岁，其中 56%的患者年龄在 45-59 岁之间。大多数损伤发生在运动时（52%），最常诊断为 5 型损伤（66%）。5%的患者有坐骨神经可触及的感觉缺失。性别比较表明，女性患者年龄明显更大，主要集中在 45-59 岁年龄组，且最常因日常生活活动受伤，而男性患者则明显更年轻，且最常见的损伤原因是运动。与 4 型和 5 型损伤相比，1 型损伤患者明显更年轻，且手术时间明显更长。
近端腘绳肌腱撕脱伤主要发生在中年患者，很少发生在 30 岁以下患者。无性别优势。女性患者通常年龄较大，在日常生活活动中受伤，而男性患者年龄较小，更多地在运动中受伤。这些流行病学数据可能有助于医生做出准确和早期的诊断。
IV。
