Persistent Tight Hamstrings Following Conservative Treatment for Apophyseal Ring Fracture in Adolescent Athletes: Critical Appraisal

Miyagi, Ryo; Sairyo, Koichi; Sakai, Toshinori; Tezuka, Fumiaki; Kitagawa, Yasuhiro; Dezawa, Akira

doi:10.2152/jmi.61.446

Cited by 5 publications

(5 citation statements)

References 20 publications

(24 reference statements)

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“…Half of the patients had to undergo surgical decompression because of epiphyseal ring rupture and compression symptoms. Surgical treatment is the most effective and main treatment for PRAF21. Currently, the choice of surgical method for lumbar PRAF is controversial.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy to Treat Posterior Ring Apophyseal Fractures: A Retrospective Cohort Study

Wang

Chen

Cao

et al. 2020

Orthopaedic Surgery

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Objective To compare the efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) and fenestration discectomy (FD) for posterior ring apophyseal fractures (PRAF). Methods This study was a retrospective cohort control study. A total of 96 patients with lumbar PRAF who underwent surgical treatment at the Henan Provincial People's Hospital of Henan University from September 2013 to December 2017 were retrospectively examined, of which 51 were treated by PTED and 45 by FD. The average age of those in the PTED group was 28.24 years, including 38 males and 13 females. The average age of those in the FD group was 28.07 years, with 33 males and 12 females. Operation time, total blood loss, hospitalization days, preoperative and postoperative visual analog scale (VAS), and Oswestry disability index (ODI) scores were evaluated. Modified MacNab criteria were used to evaluate the clinical effect at the last follow‐up. Results Both operations were successful and no serious complications occurred. All patients were followed up for 12–30 (average 16.7 ± 3.2) months, and no patients were lost to follow‐up. No statistically significant difference was found in the mean age and gender between the PTED group and the FD group (P < 0.05). Operation time, total blood loss, and length of hospital stay were significantly lower in the PTED group (87.65 ± 13.15 min, 12.78 ± 4.95 mL, and 6.80 ± 1.67 days, respectively) than in the FD group (114.11 ± 14.39 min, 30.89 ± 7.09 mL, and 11.71 ± 1.98 days, respectively) (P < 0.05). The VAS and ODI scores of the two groups at postoperative day 1 (PTED: 3.82 ± 0.97, 37.73% ± 3.72%; FD: 3.62 ± 1.09, 36.62% ± 3.05%), and at 3 months (PTED: 2.90 ± 1.08, 26.02% ± 2.90%; FD: 3.07 ± 0.99, 27.16% ± 4.02%), 6 months (PTED: 2.31 ± 0.88, 22.53% ± 2.67%; FD: 2.36 ± 0.77, 21.18% ± 3.35%), and the last follow‐up (PTED: 1.90 ± 0.83, 19.88% ± 3.01%; FD: 1.89 ± 0.86, 18.22% ± 3.03%) were significantly different from the preoperative scores (PTED: 6.53 ± 1.00, 55.24% ± 4.54%; FD: 6.78 ± 1.31, 53.56% ± 5.73%) (P < 0.05). The VAS and ODI scores at 3 months postoperatively, 6 months postoperatively, and the last follow up were not significantly different between the two groups (P > 0.05). In the PTED group, 2 patients developed a transient nerve stimulation symptom within 1 day after surgery and 1 patient had recurrence at 3 months after surgery. In the FD group, 2 patients had severe dural ruptures due to adhesion during surgery, 1 patient developed infection complications, and 2 patients relapsed at 2 and 3 months after surgery. At the last follow‐up, the modified MacNab criteria for clinical effect were 93.3% and 94.1% in the FD and PTED groups, respectively. Conclusion While PTED has the same efficacy as FD for treating PRAF, it is associated with shorter operation time, less trauma, and quicker recovery.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy to Treat Posterior Ring Apophyseal Fractures: A Retrospective Cohort Study

Wang

Chen

Cao

et al. 2020

Orthopaedic Surgery

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“…2. Chronic compression of the nerve root by both the bony fragment and the HNP would have caused the tight hamstrings (6), which in turn would not be good for professional performance. 3.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, patients are treated with conservative management (1) ; however, the clinical features tend to be prolonged and the patient could eventually require surgical intervention to remove the bony fragment (2). Even though conservative treatment would be effective to reduce pain, the residual bony fragment may cause spinal canal stenosis (1) or tightness of the hamstrings (6).…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Lumbar Herniated Nucleus Pulposus Combined with Residual Bony Fragment of Apophyseal Ring Fracture in High-Level Athletes : A Report of Two Cases

et al. 2019

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In this paper, we present 2 cases of herniated nucleus pulposus (HNP) combined with the residual bony fragment of apophyseal ring fracture. HNP typically exists at the narrow lateral recess formed by the bony fragment, and so it has been reported that symptoms may persist. Case 1 was a 22-year-old man, a high-level javelin thrower and Paralympic athlete. He had a history of persistent pain for 4 years due to HNP, and so we performed surgical removal. Case 2 was a 23-year-old male professional baseball player. He was referred to us only 17 days after the onset of pain and presented with muscle weakness, a feature which may prolong the clinical course in addition other features such as pain. Thus, we performed a comparatively quick intervention of surgical removal. In both cases, we had excellent clinical outcomes and better function and performance. In conclusion, in cases with HNP and apophyseal ring separation, surgical intervention in the comparatively early phase can be recommended, particularly if the patients desire quick return to their original level of activity. J.

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“…(4,5) The prevalence of hamstring tightness in athletes has been a subject of numerous studies in the past decade.and main cause of concern because it lead to loss of function ,reduce performance and longer recovery time. (6) A study by Gabbe et al (2010) found that hamstring tightness is prevalent in 40% of athletes, particularly those involved in sports requiring high-speed running and sudden stops. (7) Similarly, a study by Witvrouw et al reported a 37% prevalence rate among professional soccer players.…”

Section: Introductionmentioning

confidence: 99%

Association of Hamstring Tightness with Lower Extremity Injuries in Athletes (Analytical Cross-Sectional Study)

Imtiaz,

Sattar,

Qaiser

et al. 2023

PJMHS

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Background: Flexibility if muscle is required for normal bio-mechanical functioning. Muscle tightness results from reduced capability of muscle to modify its shape during movement which results in decreased ROM. Hamstring tightness is one of the cause of hamstring injuries in athletes which leads to slowed recovery and compromises performance of athlete in the field. Objective: To find the association of hamstring tightness with lower extremity injuries in athletes. Methodology: The study was conducted on 141 athletes out of those 61 were cricketers and 80 were footballers. This study was conducted from January to May 2023. Convenient sampling was used and participants were selected from different football and cricket clubs of Lahore on the basis of inclusion and exclusion criteria. Nordic questionnaire was used to determine the lower extremity injuries and active knee extension test use to measure the hamstring tightness in athletes. Statistical data was analyzed by using SPSS version 26. Result: The results showed negative correlation between Active knee Extension test and lower extremity injuries as the value of Pearson Correlation coefficient was r = -0.204. The mean±SD for Active knee Extension test was 1.31± 0.456 while that of Lower extremity Injury level was 1.28±0.56. There was significant association between AKE test and Knee pain and LBP as P-value of 0.047 amd 0.048 was obtained respectively, while there was no significant association seen between AKE test and lower extremity Injury level as p- value of 0.34 was obtined. The p-value represented that null hypothesis is accepted. Conclusion: On the basis of results Hamstring tightness is not found to be associated with Lower Extremity Injuries. While hamstring tightness could cause knee pain and low back pain in athletes. So maintaining the flexibility of hamstring in athletes could reduce the knee pain and LBP and will enhance their participation in sports. Keywords: Hamstring tightness,Nordic questionnaire ,active knee extension test.

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Persistent Tight Hamstrings Following Conservative Treatment for Apophyseal Ring Fracture in Adolescent Athletes: Critical Appraisal

Cited by 5 publications

References 20 publications

Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy to Treat Posterior Ring Apophyseal Fractures: A Retrospective Cohort Study

Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy to Treat Posterior Ring Apophyseal Fractures: A Retrospective Cohort Study

Surgical Treatment of Lumbar Herniated Nucleus Pulposus Combined with Residual Bony Fragment of Apophyseal Ring Fracture in High-Level Athletes : A Report of Two Cases

Association of Hamstring Tightness with Lower Extremity Injuries in Athletes (Analytical Cross-Sectional Study)

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