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使用缝线桥无结结构修复近端腘绳肌撕裂

Repair of Proximal Hamstring Tear Utilizing a Suture Bridge Knotless Construct.

作者信息

Sanderson Brent, Stumetz Kyle, Jazayeri Reza

机构信息

Community Memorial Health System-Department of Orthopaedic Surgery, 147 N. Brent St. Ventura, CA 93003, USA.

Pacific Northwest University School of Medicine, Butler-Haney Hall, 200 University Pkwy, Yakima, WA 98901, USA.

出版信息

Case Rep Orthop. 2020 Aug 2;2020:8840418. doi: 10.1155/2020/8840418. eCollection 2020.

Abstract

Proximal hamstring tendon injuries occur frequently in the athletic population resulting in varying degrees of functional disability depending on severity of injury. The purpose of our case vignette is to describe a surgical technique and clinical outcome for open proximal hamstring tendon repair with a confirmed biomechanically sound construct. We also describe and summarize the current literature recommendations for proximal hamstring injuries. We present a case and surgical technique report on a 27-year-old male who suffered a proximal hamstring tendon rupture. Utilizing a double row all-knotless suture bridge construct with a total of four anchors and six suture limbs allowed for anatomic footprint coverage and strength. Two years of clinical follow-up was obtained evaluating hip and knee range of motion, strength, and functional ability. Our patient underwent uncomplicated open surgical repair and returned to all activity at four months following surgery. Range of motion and strength returned to preoperative levels at the four-month postoperative mark. The use of a reproducible double row all-knotless suture bridge technique provided adequate strength and stability in the setting of a proximal hamstring tendon rupture. Open and endoscopic surgical techniques performed acutely both show positive postoperative subjective outcomes as well as a high likelihood of returning to sport. Controversy remains present in regard to the repair technique as well as postoperative bracing and physical therapy recommendations.

摘要

腘绳肌近端肌腱损伤在运动员群体中频繁发生,根据损伤严重程度导致不同程度的功能残疾。我们病例报告的目的是描述一种开放修复腘绳肌近端肌腱的手术技术及临床结果,该修复结构经证实具有良好的生物力学性能。我们还描述并总结了目前关于腘绳肌近端损伤的文献建议。我们呈现了一例27岁男性腘绳肌近端肌腱断裂的病例及手术技术报告。采用双排全无结缝线桥结构,共使用四个锚钉和六条缝线,实现了对解剖足迹的覆盖和强度。进行了两年的临床随访,评估髋关节和膝关节的活动范围、力量及功能能力。我们的患者接受了无并发症的开放手术修复,并在术后四个月恢复了所有活动。术后四个月时,活动范围和力量恢复到术前水平。在腘绳肌近端肌腱断裂的情况下,使用可重复的双排全无结缝线桥技术可提供足够的强度和稳定性。急性进行的开放手术和内镜手术技术均显示出良好的术后主观结果以及恢复运动的高可能性。关于修复技术以及术后支具和物理治疗建议仍存在争议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26c2/7422414/cc60e5e473b6/CRIOR2020-8840418.001.jpg

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