title: Diagnosis and expedited surgical intervention of a complete hamstring avulsion in a military combatives athlete: a case report.
abstract: OBJECTIVE
  Hamstring injuries are frequent injuries in athletes, with the most common being strains at the musculotendinous junction or within the muscle belly. Conversely, hamstring avulsions are rare and often misdiagnosed leading to delay in appropriate surgical interventions. The purpose of this case report is to describe the history and physical examination findings that led to appropriate diagnostic imaging and the subsequent diagnosis and expedited surgical intervention of a complete avulsion of the hamstring muscle group from the ischium in a military combatives athlete.
  
  
  METHODS
  The patient was a 25 year-old male who sustained a hyperflexion injury to his right hip with knee extension while participating in military combatives, presenting with acute posterior thigh and buttock pain. History and physical examination findings from a physical therapy evaluation prompted an urgent magnetic resonance imaging (MRI) study, which led to the diagnosis of a complete avulsion of the hamstring muscle group off the ischium.
  
  
  RESULTS
  Expedited surgical intervention occurred within 13 days of the injury potentially limiting comorbidities associated with delayed diagnosis.
  
  
  CONCLUSIONS
  Recognition of the avulsion led to prompt surgical evaluation and intervention. Literature has shown that diagnosis of hamstring avulsions are frequently missed or delayed, which results in a myriad of complications.
  
  
  METHODS
  Level 4.
authors.forename: Shaun J
authors.initials: SJ
authors.lastname: O'Laughlin
authors.affiliation: Rocky Mountain University of Health Professions, Provo, UT, USA.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Flynn
authors.affiliation: United States Military - Baylor University Sports Physical Therapy Doctoral Program, West Point, NY, USA.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Westrick
authors.affiliation: Department of Physical Therapy, University of Scranton, Scranton, PA, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Ross
keywords: Differential diagnosis; hamstring avulsion; imaging