Hughes C, Hasselman C T, Best T M, Martinez S, Garrett W E
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Am J Sports Med. 1995 Jul-Aug;23(4):500-6. doi: 10.1177/036354659502300422.
Rectus femoris muscle strain injuries commonly occur at the distal muscle-tendon junction of the quadriceps tendon. However, we have recently recognized a pattern of strain injury that consists of an incomplete intrasubstance tear at the muscle-tendon junction formed by the deep tendon of the muscle's indirect head and those muscle fibers originating from this tendon. These injuries are found more proximally within the thigh than the "classic" distal rectus femoris muscle strain. We reviewed 10 athletes with these intrasubstance tears, all of whom had diagnostic imaging performed using computed tomography or magnetic resonance imaging or both. Two of these patients required surgical intervention. The mechanism of injury usually involved kicking or sprinting. All patients had chronic thigh pain or an anterior thigh mass or both. Physical examination revealed thigh asymmetry and a nontender to mildly tender intrasubstance muscle mass. Magnetic resonance imaging demonstrated abnormal signal intensity centered about the intramuscular tendon of the indirect head of the muscle. Surgical findings included a mass of fibrous scar and fatty tissue encasing the deep tendon. Surgical removal of this fibrous mass appears curative. We contrast this injury from distal strains of the rectus femoris muscle, as well as from soft tissue neoplasms.
股直肌拉伤通常发生在股四头肌肌腱的远端肌肉-肌腱连接处。然而，我们最近认识到一种拉伤模式，它是由肌肉间接头的深部肌腱与起源于该肌腱的肌纤维形成的肌肉-肌腱连接处的不完全实质内撕裂组成。这些损伤在大腿内比“经典”的股直肌远端拉伤位置更靠近近端。我们回顾了10例有这些实质内撕裂的运动员，他们都进行了计算机断层扫描或磁共振成像或两者兼有的诊断性成像。其中2例患者需要手术干预。损伤机制通常包括踢腿或短跑。所有患者都有慢性大腿疼痛或大腿前部肿块或两者皆有。体格检查发现大腿不对称，实质内肌肉肿块无压痛至轻度压痛。磁共振成像显示异常信号强度集中在肌肉间接头的肌内肌腱周围。手术发现包括包裹深部肌腱的纤维瘢痕和脂肪组织肿块。手术切除这种纤维性肿块似乎可治愈。我们将这种损伤与股直肌远端拉伤以及软组织肿瘤进行了对比。
