Complete Proximal Hamstring Avulsions

BACKGROUND: Complete proximal hamstring avulsions can cause considerable morbidity and are often associated with significant functional loss. HYPOTHESIS: Early surgical treatment leads to better results than does surgery in the chronic phase. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Forty-one patients (21 men and 20 women) with a complete proximal hamstring avulsion were included. The cases were retrospectively analyzed, and a 4-category rating system was used to evaluate the overall result of the surgical treatment. RESULTS: The mean follow-up was 37 months (range, 12-72 months). Nineteen patients were rated as having an excellent result and 10 patients a good result. In 5 patients, the result was classified as moderate and in 7 patients poor. In the patients with an excellent or good result, the delay from the injury to surgery averaged 2.4 months, whereas in patients with a moderate or poor result, the delay averaged 11.7 months. The difference was statistically significant (P < .001). CONCLUSION: Excellent or good results can often be expected with surgery, and considerable improvement of symptoms may be achieved even in chronic cases. According to the results, early operative treatment in complete proximal avulsions of the hamstring muscles gives better results than does late surgery and is therefore recommended.