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Case Reports
. 2021 Dec;11(12):101-104.
doi: 10.13107/jocr.2021.v11.i12.2588.

Proximal Hamstring Repair - Surgical Pearls for the Novice

Supreet Bajwa  1 , Chris Erian  1 , Sikta Samantray  1 , Frank Connon  1 , Daevyd Rodda  1
Affiliations
Case Reports

Proximal Hamstring Repair - Surgical Pearls for the Novice

Supreet Bajwa et al. J Orthop Case Rep. 2021 Dec.

Abstract

Introduction: Proximal hamstring injuries are rarely encountered sport injuries which cause great functional impairment in the activities of performance. Since these injuries are rarely encountered in orthopedic training, many young surgeons find it challenging to explore and successfully perform the required repairs. The technical demands of tendon retraction, scar tissue formation along with a great possibility of nerve injury during surgical dissection make these procedures a nightmare for young surgeons.

Results: Between January 2020 and December 2021, 11 patients underwent a proximal hamstring repair at our practice. All cases were of acute hamstring tears and diagnosed on magnetic resonance imaging (MRI) evaluation post-injury. No repeat MRI was performed but the patients outcomes were judged based on clinical outcomes such as return to sport or the presence of residual pain. All patients reached their pre-injury level of activity within 6 months of surgical repair.

Conclusion: This technical note describes pearls of surgical repair of these injuries that help in better execution of such injuries with minimal soft tissue damage and complications.

Keywords: Proximal Hamstring tear; hamstring avulsion; hamstring repair.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
Anatomy of Hamstring muscles. (a) Semi-membranous, (b) Semi-tendinosus, (c) Biceps femoris, (d) Sciatic nerve.
Figure 2
Figure 2
Preoperative positioning and preparation of limb for surgery.
Figure 3
Figure 3
Palpation of ischial tuberosity as a bony landmark for surgical incision.
Figure 4
Figure 4
Hematoma at the origin of proximal hamstring rupture.
Figure 5
Figure 5
Identifying the tendon stump with three tendon tear.
Figure 6
Figure 6
Placement of suture anchor at the ischial tuberosity.
Figure 7
Figure 7
Sutured tendon to ischial tuberosity.
See this image and copyright information in PMC

References

    1. Cvetanovich GL, Saltzman BM, Ukwuani G, Frank RM, Verma NN, Bush-Joseph CA, et al. Anatomy of the pudendal nerve and other neural structures around the proximal hamstring origin in males. Arthroscopy. 2018;34:2105–10. - PubMed
    1. Dierckman BD, Guanche CA. Endoscopic proximal hamstring repair and ischial bursectomy. Arthrosc Tech. 2012;1:e201–7. - PMC - PubMed
    1. Moatshe G, Chahla J, Vap AR, Ferrari M, Sanchez G, Mitchell JJ, et al. Repair of proximal hamstring tears:A surgical technique. Arthrosc Tech. 2017;6:e311–7. - PMC - PubMed
    1. Suppauksorn S, Nwachukwu BU, Beck EC, Okoroha KR, Nho SJ. Endoscopic approach to proximal hamstring avulsion repair. JBJS Essent Surg Tech. 2020;10:e19–00037. - PMC - PubMed
    1. Blakeney WG, Zilko SR, Edmonston SJ, Schupp NE, Annear PT. A prospective evaluation of proximal hamstring tendon avulsions:Improved functional outcomes following surgical repair. Knee Surg Sports Traumatol Arthrosc. 2017;25:1943–50. - PubMed

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