Delayed sciatic neuropathy after distal semimembranosus muscle rupture associated with tethering of the sciatic nerve by a rare distal muscular branch

Abstract

Hamstring rupture usually occurs in professional athletes, but is rarely associated with sciatic neuropathy. Proximal hamstring rupture is much more often reported than distal rupture. Entrapment of the sciatic nerve from perineural scarring and muscle fibrosis is responsible for late neurologic sequelae of injury to the hamstring muscles. There is currently no literature reporting the incidence of acute or delayed sciatic neuralgia after proximal hamstring muscle rupture. The association between distal hamstring rupture and sciatic nerve injury is extremely rare. A few cases of isolated rupture of the distal semimembranosus tendon complex have been reported recently, but without neurological sequelae. We present the first case of distal semimembranosus muscle rupture with delayed sciatic neuropathy and explain its unusual cause other than perineural scarring.