Management of Chronic Proximal Hamstring Ruptures: Surgical Treatment

Proximal hamstring ruptures are often associated with a delay in diagnosis. Patients with continued disability for months or even years after this injury, present the surgeon with unique treatment dilemmas. Several studies have shown inferior results with primary repair or tenodesis of chronic ruptures when compared with acute surgical intervention. Reports after distal fractional lengthening with proximal repair and allograft reconstruction of chronic ruptures have shown improved outcomes, approaching those seen after acute repair. The current article describes the typical presentation, treatment options, and outcomes after surgical management of chronic proximal hamstring ruptures. In addition, a specific technique for Achilles allograft reconstruction is outlined in detail.