Proximal Hamstring Avulsion through Growth Plate: Case Reportof an Innovative Solution with Early Return to Sports

Abstract

Introduction: Proximal hamstring avulsion injuries significantly impact young athletes, particularly when involving growth plates. This case report and literature review aim to provide a comprehensive analysis of proximal hamstring avulsion through the growth plate, focusing on an innovative surgical solution designed to ensure early return to sports.

Case Presentation: A 13-year-old male soccer player presented with acute posterior thigh pain following a match. Initial conservative management failed to relieve symptoms. Radiographic imaging and MRI confirmed a proximal hamstring avulsion through the growth plate. The innovative surgical intervention involved reattachment using two 2.5 mm triple-loaded soft anchors to avoid growth plate interference and potential future reinterventions. Postoperative rehabilitation included phased exercises starting with painfree mobility and progressing to strength training and sport-specific drills, leading to a full recovery within six months.

Discussion: Surgical indications for hamstring avulsion include significant displacement of the avulsed fragment (>1-2 cm), conservative treatment failure, severe functional loss, and high-demand athletes requiring robust repair. Early MRI diagnosis, tailored surgical techniques avoiding growth plate disruption, and structured rehabilitation programs focusing on muscle balance and flexibility are crucial. Literature underscores the importance of early surgical
intervention, as population-based studies show tailored rehabilitation reduces recurrence and improves functional outcomes.

Conclusion: Proximal hamstring avulsion injuries in young athletes require meticulous diagnosis and treatment. The innovative use of soft anchors facilitates proper healing and early return to sports, highlighting the necessity for precise surgical techniques and comprehensive rehabilitation protocols. This integrated approach ensures optimal recovery, minimizes re-injury risks, and facilitates a safe return to high-level athletic activities.