Complete Semimembranosus Rupture during Therapeutic Stretching after Severe Traumatic Brain Injury: The First Case Report
Acute hamstring rupture is an uncommon event often occurring in athletes undergoing high-impact sports. Such events have not been reported during neurological rehabilitation. This case report describes a 30 year-old Chinese male presenting in minimally-responsive state (Ranchos level II) 5 years after a severe traumatic brain injury. He was tetraplegic and bed bound with spasticity involving all 4 limbs and had flexion contractures of the right knee.
During an episode of inpatient rehabilitation, he developed acute swelling and bruising of the posterior proximal thigh associated with fever, tachycardia and diaphoresis. MRI showed a large soft tissue rim-enhancing mass in the right proximal hamstring muscle. During surgical exploration, complete rupture of the right semimembranosus muscle was found without evidence of pus.
The possible causative factors of hamstring rupture in this subject are reviewed. To our knowledge, this is the first such reported case. Its future implications for rehabilitation professionals will be presented.