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OP-Journal 2023; 39(02): 130-137
DOI: 10.1055/a-1980-7552
Fachwissen

Aktueller Stand zu Verletzungen der proximalen und distalen Hamstring-Sehnen

Current Status on Injuries of the Proximal and Distal Hamstring Tendons
Alexander Otto
,
Annabel Fenwick
,
Andreas Wiedl
,
Edgar Mayr
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Zusammenfassung

Die ischiokrurale Muskulatur, auch Hamstring-Muskulatur genannt, überspannt sowohl das Hüft- als auch das Kniegelenk und erleidet während sportlicher Aktivitäten häufig Verletzungen. Sehnenverletzungen der Hamstring-Muskulatur sind eine seltenere Entität als die Verletzung der Muskulatur selbst.

Allerdings kann insbesondere die Avulsion der proximalen Hamstring-Sehnen zu immobilisierenden Beschwerden mit fortwährender Einschränkung der Sportfähigkeit führen. Entsprechend dem individuellen körperlichen und sportlichen Anspruch erfolgt die weiterführende Therapie dieser klinisch relevanten Verletzung. Im Rahmen der operativen Versorgung erfolgt eine Refixation der proximalen Hamstring-Sehnen am Tuber ischiadicum. Die operative Therapie zeigte eine signifikant höhere Patientenzufriedenheit sowie eine signifikant bessere Wiederherstellung der Sportfähigkeit als ein konservatives Vorgehen. Zudem konnten Vorteile für die akute gegenüber einer verzögerten operativen Versorgung beobachtet werden.

Rupturen der distalen Hamstring-Sehnen stellen eine noch seltenere Verletzung als die der proximalen Hamstring-Sehnen dar. Dabei sind vor allem Verletzungen der distalen M.-biceps-femoris- und M.-semimembranosus-Sehne von klinischer Relevanz. Die Ruptur der distalen M.-biceps-femoris-Sehne tritt vorwiegend im Rahmen von Multiligamentverletzungen des Kniegelenks auf. Jedoch ist die Literatur betreffend Verletzungen der distalen Hamstring-Sehnen, insbesondere isolierter Sehnenrupturen, nur auf Fallserien und Fallbeschreibungen limitiert.

Dieser Artikel bietet einen umfassenden Überblick über die Therapie von proximalen und distalen Rupturen der Hamstring-Sehnen.

Rupturen der proximalen Hamstring-Sehnen sind für Patienten mit körperlichem Anspruch von besonderer Relevanz, da sie zu einer relevanten funktionellen Einschränkung führen können. Rupturen der distalen Hamstring-Sehnen stellen eine seltene Sonderform von Verletzungen der ischiokruralen Muskulatur dar. Dieser Artikel bietet einen umfassenden Überblick über die Therapie von proximalen und distalen Rupturen der Hamstring-Sehnen.

Abstract

As biarticular muscles, the hamstring muscles span hip as well as the knee joint. The hamstring muscles are affected most by sports-related musculoskeletal injuries. However, avulsions of the hamstring muscle tendons are rare injuries.

Nevertheless, proximal hamstring tendon avulsions can lead to immobilizing complaints with constant physical limitations. Adequate therapy is chosen under consideration of the patients’ individual physical demands. For surgical repair, a reattachment of the tendons to the ischial tuberosity is performed. Surgical treatment resulted in significant higher patients’ satisfaction and return to sports as non-operative treatment. Furthermore, surgical treatment resulted in better clinical outcomes in acute than in chronic cases.

Avulsions of the distal hamstring tendons represent injuries that are even more rare than proximal hamstring avulsions. Especially, the distal biceps femoris tendon and the semimembranosus tendon are of clinical relevance. Multiligamentous knee injuries can often include lesions to the distal biceps femoris tendon as well. Unfortunately, the literature is limited to case series and case reports and does not provide a treatment algorithm for distal hamstring tendon injuries.

This article provides an overview for the treatment of proximal as well as distal hamstring avulsions.

Schlüsselwörter

proximale Hamstringsehnen - distale Hamstringsehnen - M. biceps femoris - M. semimembranosus - M. semitendinosus - Sehnenruptur - Therapie

Keywords

proximal hamstring tendons - distal hamstring tendons - M. biceps femoris tendon - M. semimembranosus - M. semitendinosus - tendon avulsion - treatment


Publication History

Article published online:
06 July 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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