Sarimo J, Lempainen L, Mattila K, Orava S.

Hamstring injuries are common, especially in athletes. They are particularly associated with
sports that involve running and jumping, as well as rapid acceleration and deceleration. The
spectrum of hamstring injuries spans from minor strains to partial tears to complete
avulsions of 1, 2, or all 3 tendons. Severe hamstring injuries in which one or more tendons
are completely torn or avulsed are typically characterized by a sudden onset of posterior
thigh pain associated with localized tenderness in the upper thigh and some degree of loss
of function. When a more serious injury than just a hamstring strain is suspected, magnetic
resonance imaging should be done to confirm the diagnosis. Magnetic resonance image
provides anatomical detailed information on the hamstrings and their pathology and it can
be used to assess the amount of tendon retraction, which is an important feature for
preoperative planning in proximal hamstring avulsions. In complete 1- or 2-tendon avulsions
of the proximal hamstrings, surgical treatment should be considered the treatment of
choice, at least in high level athletes. If, however, nonoperative treatment is chosen,
surgery can be a useful option, also later should the conservative treatment fail. In this
article, the indications of surgery in proximal 1- or 2-tendon hamstring avulsions are
discussed, and the operative technique is presented.

Oper Tech Sports Med 17:229-233

KEYWORDS hamstrings, hamstring tear, hamstring avulsion, hamstring rupture

Read article: Sarimo et al Oper Tech 2009 One and Two Tendon Avulsions (pdf)