Bogwasi Lone, Holtzhausen Louis, Janse van Rensburg Dina Christa, Jansen van Rensburg Audrey, Botha Tanita
Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Aspetar Orthopedic and Sports Medicine Hospital, Weill-Cornell Medical College; Qatar.
Biol Sport. 2023 Apr;40(2):497-512. doi: 10.5114/biolsport.2023.116454. Epub 2022 Jul 21.
Rectus femoris (RF) injury is a concern in sports. The management RF strains/tears and avulsion injuries need to be clearly outlined. A systematic review of literature on current management strategies for RF injuries, and to ascertain the efficacy thereof by the return to sport (RTS) time and re-injury rates. Literature search using Medline via PubMed, WorldCat, EMBASE, SPORTDiscus. Eligible studies were reviewed. Thirty-eight studies involving hundred and fifty-two participants were included. Majority (n = 138; 91%) were males, 80% (n = 121) sustained RF injury from kicking and 20% (n = 31) during sprinting. The myotendinous (MT), (n = 27); free tendon (FT), (n = 34), and anterior-inferior iliac spine (AIIS), (n = 91) were involved. Treatment was conservative (n = 115) or surgical (n = 37) across the subgroups. 73% (n = 27) of surgical treatments followed failed conservative treatment. The mean RTS was shorter with successful conservative treatment (MT: 1, FT: 4, AIIS avulsion: 2.9 months). Surgical RTS ranged from 2-9 months and 18 months with labral involvement. With either group, there was no re-injury within 24 months follow-up. With low certainty of evidence RF injury occurs mostly from kicking, resulting in a tear or avulsion at the FT and AIIS regions with or without a labral tear. With low certainty, findings suggest that successful conservative treatment provides a shortened RTS. Surgical treatment remains an option for failed conservative treatment of RF injuries across all subgroups. High-level studies are recommended to improve the evidence base for the treatment of this significant injury.
股直肌（RF）损伤是运动领域关注的问题。需要明确阐述股直肌拉伤/撕裂和撕脱伤的处理方法。对有关RF损伤当前处理策略的文献进行系统综述，并通过恢复运动（RTS）时间和再损伤率来确定其疗效。通过PubMed、WorldCat、EMBASE、SPORTDiscus使用Medline进行文献检索。对符合条件的研究进行了综述。纳入了38项涉及152名参与者的研究。大多数（n = 138；91%）为男性，80%（n = 121）因踢腿导致RF损伤，20%（n = 31）在短跑时受伤。涉及肌腱-肌肉结合部（MT）（n = 27）、游离肌腱（FT）（n = 34）和髂前下棘（AIIS）（n = 91）。各亚组的治疗方式为保守治疗（n = 115）或手术治疗（n = 37）。73%（n = 27）的手术治疗是在保守治疗失败后进行的。成功的保守治疗平均RTS较短（MT：1个月，FT：4个月，AIIS撕脱伤：2.9个月）。手术治疗的RTS范围为2 - 9个月，伴有盂唇损伤时为18个月。在两组中，24个月随访内均未出现再损伤。证据确定性较低，RF损伤大多因踢腿所致，导致FT和AIIS区域出现撕裂或撕脱伤，伴或不伴有盂唇撕裂。证据确定性较低，研究结果表明成功的保守治疗可缩短RTS。对于所有亚组中RF损伤保守治疗失败的情况，手术治疗仍是一种选择。建议开展高水平研究以改善对这种严重损伤治疗的证据基础。
