Distal semitendinosus rupture in a rugby union player: An algorithmic approach to assist treatment decision

Bikram Karmakar


Literature regarding the management of distal semitendinosus rupture is limited. Though uncommon, distal semitendinosus rupture does occur, particularly in athletes. Clinicians are presented with a treatment dilemma in choosing between non-operative and operative methods without a consensus in the management approach. This is particularly challenging when managing patients who demand optimum function after recovery from injury. This was also the situation in the case that is reported in this paper. Using available literature, a treatment algorithm has been formulated in the form of a flowchart to simplify the decision-making process. The treatment flowchart guides the clinician in the initial treatment decision and specific patient measures that can determine treatment success. This approach was used successfully in the management of the case presented. The patient outcome focussed algorithm ensures that their functional goals are prioritised and any complications that occur in the treatment process can be addressed in a timely manner. The overall goal of whichever treatment process is chosen is for the patient to return to an optimal level of function.


athletic injuries, hamstring, rehabilitation

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