Z Orthop Unfall 2022; 160(01): 99-104
DOI: 10.1055/a-1202-1887
Case Report/Fallbericht

Pronounced Heterotopic Ossifications after Traumatic Hamstring Rupture: Is an Ossification Prophylaxis Useful?

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Philipp Hemmann
1   Unfall- und Wiederherstellungschirurgie, Berufsgenossenschaftliche Unfallklinik Tübingen
,
Anna Janine Schreiner
1   Unfall- und Wiederherstellungschirurgie, Berufsgenossenschaftliche Unfallklinik Tübingen
,
Leonie Frauenfeld
2   Institut für Pathologie und Neuropathologie und Comprehensive Cancer Center, University of Tübingen, Eberhard Karls Universität Tübingen
,
Ulrich Stöckle
3   Centrum für Muskuloskeletale Chirurgie, Charité – Universitätsmedizin Berlin
,
Florian Schmidutz
1   Unfall- und Wiederherstellungschirurgie, Berufsgenossenschaftliche Unfallklinik Tübingen
4   Klinik und Poliklinik für Orthopädie, Physikalische Medizin und Rehabilitation, Ludwig-Maximilians-Universität München
› Institutsangaben

Abstract

Hamstring injuries include a wide range of injuries and affect mainly athletes with high eccentric loads (football, athletics, rugby, climbing). According to the latest literature, unrecognized traumatic ruptures can cause permanent discomfort and may be associated with a poorer postoperative outcome when delayed surgical therapy is performed. Heterotopic ossifications (HO) after hamstring rupture have been described in individual case reports and smaller studies so far. Heterotopic ossifications are mainly known in hip surgery and elbow fractures. In this case report, a 48-year-old patient presented with an increasing swelling with hardening in the area of the right ischial tuberosity. One year before, an impact trauma was the reason for a traumatic hamstring rupture which was diagnosed with a delay. The HO was excised and the tendon refixed with two suture anchors. By limiting the range of motion with a hip-knee orthosis for 9 weeks, a regular postoperative healing process was observed. Heterotopic ossifications after hamstring ruptures have been reported repeatedly but have not been evaluated in any major study so far. It should therefore be considered whether prophylaxis with NSAIDs should be used for conservatively and surgically treated hamstring ruptures, analogous to the ossification prophylaxis for hip endoprostheses or fractures in the elbow region.



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Artikel online veröffentlicht:
03. August 2020

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