Avulsion fracture of the anterior superior iliac spine following apophysitis

Pointinger, H.; Munk, Peter L.; Poeschl, G.

doi:10.1136/bjsm.37.4.361

Cited by 44 publications

(31 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These cases are primarily indicated for surgical intervention [3]. The displacement of the fragment >3 cm should be also considered for open reduction [4,10]. As this is a rare injury, few studies compare outcomes of conservative vs. surgical treatment [1,5,6].…”

Section: Discussionmentioning

confidence: 99%

“…Conservative treatment is traditionally two to three weeks of limited activities and walking, with partial weight bearing using crutches [1,2,[4][5][6]10], and provides good clinical results. Severely displaced fragments may cause compression of the lateral cutaneous nerve, causing meralgia paraesthetica [3,7].…”

Section: Discussionmentioning

confidence: 99%

“…It is usually caused by sudden strain on the sartorius muscle or the tensor of the fascia lata during the starting phase of running or jumping [1][2][3][4]. Sports with the highest risk of this injury include running, soccer and ice hockey.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of conservative against surgical treatment of anterior–superior iliac spine avulsion fractures in children and adolescents

Kautzner

Trč

Havlas

2014

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose Avulsion fracture of the anterior-superior iliac spine is an uncommon injury. It is mostly seen in adolescent sprinters, distance runners and soccer players. Most cases are unilateral. We present a cohort of patients and the strategy for their treatment. Methods During the period 2005-2012, we treated 23 (19 male, four female) patients with an average age of 15.1 years (4-17). Ten patients with minimally displaced fractures were treated conservatively, and 13 patients with greater fragment dislocation were treated surgically. All patients underwent the standardised rehabilitation protocol. We evaluated range of motion (ROM), X-ray six weeks and one year postoperatively, length of bed rest, return to activity and complication rates (infection, heterotopic ossification). Results All patients returned to sports at the preinjury level. Surgically treated patients showed faster recovery and better compliance with rehabilitation protocols. The time interval for X-ray union was comparable between groups, as was full recovery. There was no deep infection; however, there were five minor heterotopic ossifications, none of which required further treatment. Conclusion We emphasise that the indication for surgical treatment is mainly determined by the grade of fragment displacement and the patient's sporting activity. Although long-term results were comparable between treatment methods, surgery carries the risk of higher complication rates and the need for osteosynthetic material extraction.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of conservative against surgical treatment of anterior–superior iliac spine avulsion fractures in children and adolescents

Kautzner

Trč

Havlas

2014

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…Open reduction and internal fixation is also recommended when the fragment is displaced more than 3 cm. 4 One of the authors has treated eight adolescent patients with unilateral ASIS avulsion over the last 6 years. 9 Seven cases were successfully treated nonoperatively, but in one patient ORIF was performed because of fragment displacement over 3 cm.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous bilateral avulsion fracture of the anterior superior iliac spine in a young athlete

et al. 2007

View full text Add to dashboard Cite

A 16-year-old boy was running a 100 m sprint. About 40 m from the starting line, he felt a sharp snap in his right groin with moderate sudden pain. As he decelerated, there was similar snap with sudden pain in the left groin. He collapsed to the ground with moderate pain over both the groins. He was unable to get up from the ground and had to be carried off on a stretcher.On arrival in the emergency department by ambulance about an hour from the time of injury, the pain was still localised to both the groins and had somewhat subsided with analgesics. On examination, he was of moderate build with good muscular tone. His height was 178 cm and weight 72 kg. He had no obvious bruising or swelling. There was no deformity of the lower limbs, with both being held in neutral rotation. He was tender anteriorly over the hip and the anterior aspect of the iliac crest on both sides. Both hips were held in about 208 of flexion with the knees flexed to about 308. He was unable to straighten his leg. Rotational movements were not possible. Distal sensation and circulation were normal.A radiograph of the pelvis was performed which showed bilateral avulsion of the anterior superior iliac spine (ASIS) with almost symmetrical caudal displacement of the avulsed bony fragment on both the sides by about 2 cm (Figs. 1-3). This was confirmed on MRI scan.Full bone profile laboratory tests, full blood count, full biochemistry tests as well as growth and thyroid hormone levels were all normal.He was treated with analgesia and full bed rest in a semi-flexed hip position in 45-908 flexion for the first 2 weeks. A check X-ray at 2 weeks showed initial signs of callus formation and he was started on a course of gradual physiotherapy with increasing hip extension gaining full weight bearing training by 4 weeks and full ROM at 6 weeks (Figs. 4 and 5). He was kept on crutches until he regained full ROM in both hips at 4 weeks, and he returned to full sports activities and was free from pain by 10 weeks after the injury. Radiographs at 3 months showed both fractures were fully healed (Figs. 6-8).

show abstract

“…They are the sites of muscle origin or tendon insertion and are therefore subjected to traction type forces when muscles contract. Sudden explosive muscle contraction can cause an acute avulsion while chronic repetitive forces can cause an inflammatory apophysitis 1 – 3…”

Section: Discussionmentioning

confidence: 99%

Simultaneous bilateral avulsion fractures of the anterior superior iliac spines in an adolescent sprinter

Boyce

Quigley²

2009

Case Reports

View full text Add to dashboard Cite

A 16-year-old boy presented to the emergency department with sudden onset of bilateral hip pain while performing in a 100 m sprint race. Examination revealed diffuse swelling and tenderness at both anterior superior iliac spines (ASIS). Pelvic x ray revealed bilateral displaced avulsion fractures of the ASIS at the origin of the sartorius muscle. He was managed conservatively with analgesia and bed rest with both hips held partially flexed at approximately 60°. Further x rays showed good healing and no further displacement of the avulsed fragments. Following physiotherapy he had a full range of hip movements at 6 weeks post-injury. He was able to return to full activity by 18 weeks post-injury.

show abstract

Avulsion fracture of the anterior superior iliac spine following apophysitis

Cited by 44 publications

References 10 publications

Comparison of conservative against surgical treatment of anterior–superior iliac spine avulsion fractures in children and adolescents

Comparison of conservative against surgical treatment of anterior–superior iliac spine avulsion fractures in children and adolescents

Simultaneous bilateral avulsion fracture of the anterior superior iliac spine in a young athlete

Simultaneous bilateral avulsion fractures of the anterior superior iliac spines in an adolescent sprinter

Contact Info

Product

Resources

About