Abstract：
The purpose of this current concepts review is to highlight the evaluation and workup of hamstring injuries, nonoperative treatment options, and surgical decision-making based on patient presentation and injury patterns. Hamstring injuries, which are becoming increasingly recognized, affect professional and recreational athletes alike, commonly occurring after forceful eccentric contraction mechanisms. Injuries occur in the proximal tendon at the ischial tuberosity, in the muscle belly substance, or in the distal tendon insertion on the tibia or fibula. Patients may present with ecchymoses, pain, and weakness. Magnetic resonance imaging remains the gold standard for diagnosis and may help guide treatment. Treatment is dictated by the specific tendon(s) injured, tear location, severity, and chronicity. Many hamstring injuries can be successfully managed with nonoperative measures such as activity modification and physical therapy; adjuncts such as platelet-rich plasma injections are currently being investigated. Operative treatment of proximal hamstring injuries, including endoscopic or open approaches, is traditionally reserved for 2-tendon injuries with >2 cm of retraction, 3-tendon injuries, or injuries that do not improve with 6 months of nonoperative management. Acute surgical treatment of proximal hamstring injuries tends to be favorable. Distal hamstring injuries may initially be managed nonoperatively, although biceps femoris injuries are frequently managed surgically, and return to sport may be faster for semitendinosus injuries treated acutely with excision or tendon stripping in high-level athletes.
摘要：
当前概念审查的目的是强调腿筋损伤的评估和检查，非手术治疗方案,以及基于患者表现和损伤模式的手术决策。腿筋受伤,越来越多的人认识到，对职业运动员和休闲运动员都有影响，通常发生在强力偏心收缩机制之后。损伤发生在坐骨结节的近端肌腱，在肌肉腹部物质中，或在胫骨或腓骨的远端肌腱插入。患者可能出现瘀斑，疼痛,和弱点。磁共振成像仍然是诊断的金标准，可能有助于指导治疗。治疗由受伤的特定肌腱决定，撕裂位置,严重程度,和慢性。许多腿筋损伤可以通过非手术措施成功治疗，例如活动改变和物理治疗；目前正在研究诸如富含血小板的血浆注射之类的辅助手段。近端腿筋损伤的手术治疗,包括内窥镜或开放入路，传统上是为2-肌腱损伤保留的，缩回>2厘米，3-肌腱损伤,或在6个月的非手术治疗中没有改善的损伤。近端腿筋损伤的急性手术治疗往往是有利的。腿筋远端损伤最初可以非手术治疗，虽然股二头肌损伤经常通过手术治疗，在高水平运动员中，对于通过切除或肌腱剥离急性治疗的半腱肌损伤，恢复运动可能会更快。
