The Proximal Origin of the Hamstrings and Surrounding Anatomy Encountered During Repair
- 1 January 2007
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Journal of Bone & Joint Surgery
- Vol. 89 (1), 44-48
- https://doi.org/10.2106/jbjs.f.00094
Abstract
Background: Avulsion of the proximal origin of the hamstrings has become a more frequently recognized athletic injury. Most orthopaedic surgeons rarely operate in this anatomic area. The purpose of the present study was to define the anatomy of the proximal origin of the hamstrings and its relationship to neurovascular and muscular structures encountered during a repair of a complete avulsion. Methods: Fourteen fresh-frozen hip-to-foot human cadaveric specimens were dissected in the prone position. The proximal origin of the hamstrings and its relationship to the surrounding neurologic and muscular structures were documented and measured with use of digital calipers. Results: Six of the fourteen specimens were from female donors. The average age of the donors at the time of death was 68 ± 13 years. The average height of the donors was 66 ± 3.5 in (167 ± 8.9 cm), and the average weight was 142 ± 39 lb (64 ± 17.7 kg). The semitendinosus and biceps femoris have a common tendinous site of origin on the ischium. A number of measurements were obtained. The musculotendinous junctions of the semitendinosus and biceps femoris separated at an average of 9.9 ± 1.5 cm from the most proximal origin site on the ischium. The average distance from the proximal border of the semitendinosus/biceps femoris origin to the inferior border of the gluteus maximus was 6.3 ± 1.3 cm. At the lateral border of the ischium, the average distance from the inferior gluteal nerve and artery to the inferior border of the gluteus maximus was 5.0 ± 0.8 cm. The sciatic nerve was an average of 1.2 ± 0.2 cm from the most lateral aspect of the ischial tuberosity. The site of origin of the semitendinosus/biceps femoris was oval, with average measurements of 2.7 ± 0.5 cm from proximal to distal and of 1.8 ± 0.2 cm from medial to lateral. The site of origin of the semimembranosus was crescent-shaped, with average measurements of 3.1 ± 0.3 cm from proximal to distal and of 1.1 ± 0.5 cm from medial to lateral. Conclusions: The semitendinosus and biceps femoris have a common tendon of origin on the ischium, and the semimembranosus originates just laterally. The proximal origin of the hamstrings has intimate relationships with the inferior gluteal nerve and artery and the sciatic nerve, which may be at risk during surgical dissection and retraction.Keywords
This publication has 10 references indexed in Scilit:
- Surgical repair of complete proximal hamstring tendon ruptures in water skiers and bull riders: a report of four cases and review of the literatureBritish Journal of Sports Medicine, 2005
- Functional assessment after acute and chronic complete ruptures of the proximal hamstring tendonsKnee Surgery, Sports Traumatology, Arthroscopy, 2004
- Avulsion of the Common Hamstring Tendon Origin in an Active Duty AirmanMilitary Medicine, 2003
- Surgical Repair of Complete Proximal Hamstring Tendon RuptureThe American Journal of Sports Medicine, 2002
- Chronic Complete Hamstring Avulsion Causing Foot Drop: A Case ReportThe American Journal of Sports Medicine, 2000
- Surgical Repair of Chronic Complete Hamstring Tendon Rupture in the Adult PatientThe American Journal of Sports Medicine, 1998
- Hamstring Strains in Athletes: Diagnosis and TreatmentJournal of the American Academy of Orthopaedic Surgeons, 1998
- Hamstring Muscle Injuries Among Water SkiersThe American Journal of Sports Medicine, 1996
- Rupture of the Ischial Origin of the Hamstring MusclesThe American Journal of Sports Medicine, 1995
- Radiographic imaging of muscle strain injuryThe American Journal of Sports Medicine, 1993