Iatrogenic injury to the sciatic nerve during surgical repair of proximal hamstring avulsion

2015 ◽  
Vol 52 (3) ◽  
pp. 465-466 ◽  
Author(s):  
Vasudeva G. Iyer
Keyword(s):  
Sciatic Nerve ◽  
Surgical Repair ◽  
Iatrogenic Injury ◽  
Proximal Hamstring Avulsion ◽  
Proximal Hamstring

scholarly journals Sciatic Nerve Injury After Proximal Hamstring Avulsion and Repair

2017 ◽  
Vol 5 (7) ◽  
pp. 232596711771368 ◽  
Author(s):  
Thomas J. Wilson ◽  
Robert J. Spinner ◽  
Rohith Mohan ◽  
Christopher M. Gibbs ◽  
Aaron J. Krych
Keyword(s):  
Sciatic Nerve ◽  
Nerve Injury ◽  
Sciatic Nerve Injury ◽  
Proximal Hamstring Avulsion ◽  
Proximal Hamstring

scholarly journals Incidence of Symptomatic Venous Thromboembolism in Proximal Hamstring Repair: A Prospective Cohort Study

2021 ◽  
Vol 9 (7) ◽  
pp. 232596712110124
Author(s):  
Ajay Asokan ◽  
Ricci Plastow ◽  
Justin S. Chang ◽  
Babar Kayani ◽  
Peter Moriarty ◽  
...  
Keyword(s):  
Cohort Study ◽  
Venous Thromboembolism ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Surgical Repair ◽  
Early Mobilization ◽  
Compression Stockings ◽  
Level Of Evidence ◽  
Proximal Hamstring Avulsion ◽  
Proximal Hamstring

Background: Surgical repair of proximal hamstring avulsion injuries can enable the return to preinjury levels of sporting function and minimize the risk of recurrence in both professional and recreational athletes. While venous thromboembolism (VTE) is a recognized complication of surgical repair, the incidence thereof is poorly reported in the literature. Purpose/Hypothesis: To report the incidence of symptomatic VTE after proximal hamstring avulsion repair and assess the efficacy of our thromboprophylaxis protocol. It was hypothesized that the incidence of VTE after proximal hamstring avulsion repair is low and that aspirin is an adequate choice of chemical prophylaxis. Study Design: Cohort study; Level of evidence, 2. Methods: We performed a prospective cohort study of 2 groups of patients who underwent proximal hamstring avulsion (partial and complete) repair between 2000 to 2020 with different thromboprophylaxis protocols. No patients were routinely screened for VTEs, and VTE was investigated only if clinically indicated. Prospectively collected data included demographics, the mechanism and sport that caused injury, use of bracing, and clinical diagnosis of deep vein thrombosis (DVT) or pulmonary embolism (PE). The first cohort (n = 380) was given mechanical prophylaxis in the form of compression stockings for 6 weeks postoperatively. The second cohort (n = 600) was given compression stockings and aspirin 150 mg once daily routinely, or prophylactic low–molecular weight heparin in high-risk individuals, until the 6-week follow-up. Patients in both cohorts underwent early mobilization after surgery; a hinged knee brace locked at 60° to 120° was provided if the tendon repair was under significant tension. The surgical technique and rehabilitation protocol remained consistent throughout the study. Results: The overall incidence of symptomatic VTE was 0.51%. A total of 5 patients developed symptomatic VTEs (3 DVTs, 2 PEs) in the first cohort, and no patients developed symptomatic VTEs in the second cohort (1.32% vs 0%; P = .0048). Conclusion: The incidence of symptomatic VTE after proximal hamstring avulsion repairs was extremely low. A combination of aspirin, early mobilization despite bracing, compression stockings, and good hydration was an effective thromboprophylaxis strategy.

Exploring the Perth Hamstring Assessment Tool and Lower Extremity Functional Scale in a Proximal Hamstring Avulsion Cohort: A Cross-sectional Study

2021 ◽  
pp. 036354652110085
Author(s):  
Elsa Pihl ◽  
Kenneth B. Jonsson ◽  
Mida Berglöf ◽  
Nina Brodin ◽  
Olof Sköldenberg ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Assessment Tool ◽  
Patient Specific ◽  
Activity Limitations ◽  
Functional Tests ◽  
Functional Scale ◽  
Proximal Hamstring Avulsion ◽  
Proximal Hamstring ◽  
Lower Extremity Functional Scale

Background: The goal of treatment for a proximal hamstring avulsion (PHA) is an objectively restored muscle and a subjectively satisfied, pain-free patient at follow-up. Different self-reported and performance-based outcome measures have been used to evaluate recovery, but their validity is poorly investigated. Purpose: To investigate 1) the correlation between the commonly used self-reported outcome measurements, the Perth Hamstring Assessment Tool (PHAT) and the Lower Extremity Functional Scale (LEFS); 2) to what extent these scores can be explained by physical dysfunction as measured by performance-based tests; 3) whether performance-based tests can discriminate between the injured and uninjured extremity; and 4) which activity limitations are perceived by patients several years after the injury. Study design: Cohort study (Diagnosis); Level of evidence, 3. Methods: We included a consecutive series of patients treated for or diagnosed with PHA in our department between 2007 and 2016 having at least 2 tendons avulsed from the ischial tuberosity. Participants attended 2 study visits, answered questionnaires (PHAT, LEFS, and Patient-Specific Functional Scale [PSFS]), and performed physical performance–based tests (single-leg hop tests, single–step down test, and isometric and isokinetic strength tests). Results: A total of 50 patients were included (26 men [52%], 24 women [48%]; mean age, 50.9 years [SD, 9.8 years]). The mean follow-up time was 5.5 years (SD, 2.7 years), and 74% had been surgically treated. The correlation between PHAT and LEFS was strong ( r = 0.832) and statistically significant ( P < .001). Seven of the performance-based tests exhibited a statistically significant but weak correlation with LEFS (0.340-0.488) and 3 of the tests to PHAT (–0.304 to 0.406). However, only peak torque could significantly discriminate between the extremities. The activity limitation most commonly mentioned in PSFS was running (16 patients [32%]). Conclusion: Although PHAT and LEFS correlated strongly, the correlations between functional tests and the patient-reported outcome scores were weak, and most functional tests failed to discriminate between the injured and uninjured lower extremity in patients with PHA 5 years after injury. In general, patients alleged few activity limitations, but running difficulty was a common sequela after PHA.

Atypical Coxa Saltans Due to Partial Proximal Hamstring Avulsion: A Case Presentation Highlighting the Role for Dynamic Sonography

PM&R ◽  
2015 ◽  
Vol 7 (10) ◽  
pp. 1102-1105 ◽  
Author(s):  
Luke S. Spencer-Gardner ◽  
Adam M. Pourcho ◽  
Jay Smith ◽  
Aaron J. Krych
Keyword(s):  
Case Presentation ◽  
Proximal Hamstring Avulsion ◽  
Proximal Hamstring

Proximal Hamstring Injuries: Review of Operative and Nonoperative Management

2018 ◽  
Vol 02 (04) ◽  
pp. 176-188
Author(s):  
Kyle Duchman ◽  
Ned Amendola ◽  
Joseph Buckwalter V
Keyword(s):  
Surgical Repair ◽  
Nonoperative Management ◽  
Current Evidence ◽  
Surgical Indications ◽  
Endoscopic Repair ◽  
Hamstring Injuries ◽  
Partial Tears ◽  
And Function ◽  
Proximal Hamstring ◽  
Repair Techniques

AbstractWhile uncommon, proximal hamstring injuries can result in significant pain and dysfunction, while also posing considerable treatment dilemmas due to the spectrum of injury that exists. Recent literature suggests that outcomes are improved with acute surgical repair of complete proximal hamstring avulsions, highlighting the importance of timely management of these unique injuries. While chronic repair or reconstruction can result in predictable improvements in pain and function postoperatively, the results are less predictable than acute surgical repair. Nonoperative management should be considered as the initial treatment strategy for patients with proximal hamstring tendinopathy or partial tears, as delayed surgical intervention in this setting has not been shown to significantly affect outcomes. Although current evidence is limited, evolving therapeutic techniques, including biologic injections and endoscopic repair techniques, need to be carefully evaluated to determine their role moving forward. This review aims to provide updated information on the relevant anatomy, mechanism of injury, diagnosis, and management of proximal hamstring injuries, with a specific focus on surgical indications, techniques, and outcomes.

scholarly journals Suture Bridge Repair of Proximal Hamstring Avulsion: A Case Report

2020 ◽  
Vol 3 (1) ◽  
pp. 10-15
Author(s):  
Chad A. Edwards ◽  
Brian H. Goldman ◽  
Andrew Hadeed ◽  
Daniel Kalbac
Keyword(s):  
Technical Difficulty ◽  
Suture Bridge ◽  
Patient Morbidity ◽  
Surgical Fixation ◽  
Proximal Hamstring Avulsion ◽  
Proximal Hamstring ◽  
Anchor Fixation ◽  
Suture Bridge Technique ◽  
Severe Patient

Proximal hamstring avulsion injuries can represent a challenging problem and lead to severe patient morbidity if not treated appropriately. The most common method for acute surgical fixation involves the use of between two and five suture anchors in a variety of configurations. The five-anchor fixation has become the gold standard due to the increased biomechanical stability. However, the technique has also been criticized due to the need for greater exposure and technical difficulty. We report on an individual with a proximal hamstring avulsion injury who was managed with a modified approach, utilizing only three anchors in a suture bridge technique. The patient had good clinical outcomes at their 3-month follow-up visit, demonstrating this technique to be a viable option that is less technically demanding.

Returning To Sports After Surgical Repair Of Acute Proximal Hamstring Ruptures

2013 ◽  
Vol 29 (10) ◽  
pp. e111
Author(s):  
Nicolas Lefevre ◽  
Yoann Bohu ◽  
Jean François Naouri ◽  
Shahnaz Klouche ◽  
Serge Herman
Keyword(s):  
Surgical Repair ◽  
Proximal Hamstring
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