• These tension injuries to the nerve have a tendency to affect the peroneal branch, leading to footdrop or weak inversion strength. • When there is a large fragment of bone associated with the avulsion, the callus formation during the body’s attempt to heal the fracture can lead to entrapment of the nerve and paresthesias in the distribution of the sciatic nerve.
Repair of Proximal Hamstring Avulsion
Examination/Imaging
The patient will often report an eccentric load with an audible pop (e.g., “missed the soccer ball and hit the ground with my foot”).
Patients can have difficulty with ambulation. They avoid hip and knee flexion.
There is point tenderness at the posterior thigh leading to difficulty with sitting.
A large ecchymosis develops 3 days to 1 week after the injury.
The sciatic nerve passes near the origin of the proximal hamstrings and can be injured acutely.
Radiographs can show the ischial avulsion fractures (Fig. 1).
Magnetic resonance imaging is the test of choice for differentiating partial and complete tears.
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