Avulsion Injuries of the Pelvis

Sanders, Timothy G.; Zlatkin, Michael B.

doi:10.1055/s-2008-1067936

Cited by 83 publications

(69 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These injuries easily escape attention; a delay in diagnosis may result in chronic pain and reduced sports performance, therefore an avulsion fracture should be considered as a possibility in cases with a typical history and evaluated by comparative, bilateral X-ray. Advanced imaging procedures (computerised tomography, magnetic resonance, ultrasound, or bone scintigraphy) may be used in uncertain cases (1,5).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Avulsion Fracture of the Anterior Inferior Iliac Spine among Amateur Football Players

Çıraklı¹,

Zengin²,

Sezgin³

et al. 2013

JAEMCR

View full text Add to dashboard Cite

Avulsion fractures of the pelvic apophyses among athletes in the adolescent period are rare injuries caused by sudden contraction of the adhesive muscles. Avulsion fracture of the anterior inferior iliac spine (AIIS) in a 15-year-old amateur athlete is presented. The patient's history revealed a sudden pain in the right hip when shooting the ball while playing football on a synthetic field. Pelvic radiograph showed avulsion fracture of the AIIS. The patient was given conservative treatment consisting of an analgesic, antiinflammatory treatment, and bed rest. The patient, who experienced pain relief following the medical treatment and bed rest for 3 weeks, was mobilised with hip exercises and on crutches. After the detection of union on radiographs taken at the end of the fourth week, he was mobilised with full weight bearing. The patient, who underwent an exercise programme, was allowed to participate in sporting activities at the end of the third month.Keywords: Anterior inferior iliac spine, avulsion fracture, conservative treatment Received: 20.10.2012 Accepted: 04.02.2013 ÖZET Adölesan dönemde sporcularda pelvisteki apofizlerde avulsiyon kırıkları yapışan kasların ani kasılması sonucu meydana gelen nadir yaralanmalardır. Yazımızda 15 yaşındaki amatör sporcuda meydana gelen anterior inferior iliak spine (AİİS) avulsiyon kırığı sunuldu. Hikayesinde halı sahada top oynarken şut çeken hastanın ani sağ kalça ağrısı geliştiği öğrenildi. Çekilen pelvis radyografisinde AİİS lokalizasyonunda avulsiyon kırığı gözlendi. Hastaya analjezik, antienflamatuar tedavi ve yatak istirahatinden oluşan konservatif tedavi uygulandı. Üç hafta ilaç kullanımı ve yatak istirahatinin ardından ağrıları azalan hastaya kalça egzersizleri ve koltuk değneği ile mobilizasyona başlandı. Dördüncü haftanın sonunda çekilen radyografide kaynama bulguları gözlenen hasta desteksiz mobilize edildi. Egzersiz programı uygulanan hastaya üçüncü ayın sonunda sportif faaliyetlerine başlaması için izin verildi.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Such areas represent the insertion points of the muscles of muscle groups. Avulsion fractures generally occur as a result of sudden, violent or unbalanced contractions of these muscles with an insertion in these areas, and less frequently, they may be due to direct contact and repeated stress (3,5).…”

Section: Discussionmentioning

confidence: 99%

Avulsion Fracture of the Anterior Inferior Iliac Spine among Amateur Football Players

Çıraklı¹,

Zengin²,

Sezgin³

et al. 2013

JAEMCR

View full text Add to dashboard Cite

show abstract

“…6 The management of an avulsion fracture of the lesser trochanter is usually nonoperative and supportive. 1,3,[7][8][9] Rest and nonsteroidal antiinflammatory medications are typically sufficient. Non-weight bearing is recommended.…”

Section: Discussionmentioning

confidence: 99%

Avulsion fracture of the lesser trochanter: an unusual cause of hip pain in an adolescent

Vazquez

Kim

Young

2013

CJEM

View full text Add to dashboard Cite

Sports injuries involving the hip and groin are common. Special consideration must be given to musculoskeletal injuries in children and adolescents as their immature skeletons have growth plates that are relatively weaker than the tendons and ossified bone to which they connect. We present a case of an adolescent athlete with acute-onset groin pain who was found to have an avulsion fracture of the lesser trochanter. RÉ SUMÉLes accidents du sport touchant la hanche et l'aine sont fré quents. Il faut porter une attention particuliè re aux blessures musculosquelettiques chez les enfants et les adolescents é tant donné que le squelette encore immature est constitué en partie de cartilages de conjugaison relativement plus faibles que les tendons et les piè ces ossifié es qu'ils relient. Voici le cas d'un jeune athlè te, à l'â ge de l'adolescence, chez qui est apparue une douleur subite à l'aine et qui s'est avé ré e une fracture-avulsion du petit trochanter.Keywords: adolescent, avulsion fracture, hip pain, lesser trochanter A 15-year-old African-American male presented to the pediatric emergency department (ED) with a complaint of left hip pain. The pain began while sprinting during football practice on the previous day. He reported feeling a ''pop'' deep in his left hip. This was immediately followed by severe pain and an inability to bear weight on the left lower extremity. The patient reported that he fell to the ground and required assistance from his trainers to get off the field.The patient was initially taken to another ED on the day of the injury, where he was evaluated and given the diagnosis of a muscular strain. No radiographs were obtained during that visit. He was prescribed an analgesic and a muscle relaxant and provided with crutches for ambulation.Because of the severity and persistence of the pain, the patient was brought to our pediatric ED for reevaluation. We found that he was in no distress while at rest but avoided movement of his left lower extremity. His vital signs were stable. When examined in a supine position, the patient was noted to have pain on elevation of his left leg. Rotation of the leg while in full extension did not elicit significant pain. When the patient was examined in a sitting position (with hips flexed at a 90u angle), pain was elicited with further flexion of the left hip, giving a positive Ludloff sign. The patient was noted to have an antalgic gait. A radiograph of the pelvis revealed an avulsion fracture of the apophysis of the left lesser trochanter (Figure 1). The orthopedic team was consulted and recommended non-weight bearing on the affected limb with crutches, analgesics, and clinic follow-up in 2 weeks. DISCUSSION

show abstract

“…In these injuries, the tendon applies an excessive traction force that is excessive relative to the resistance posed by an apophysis that is not fully mature and biomechanically consolidated. The pelvis is one of the most common sites for acute apophyseal injuries [4,5]. The most frequently injured apophyses in the pelvis are: the secondary ossification centre of the iliac crest (abdominal wall muscles); the anterior superior iliac spine (sartorius and tensor fasciae latae); the anterior inferior iliac spine (rectus femoris); the pubis (adductors); the ischial tuberosity (hamstrings); and the lesser trochanter (iliopsoas).…”

Section: Apophyseal Injuriesmentioning

confidence: 99%

Paediatric musculoskeletal US beyond the hip joint

et al. 2011

View full text Add to dashboard Cite

US is a technique particularly suited to the investigation of musculoskeletal disorders in children and adolescents. This review paper describes a range of clinical settings beyond the hip joint where US has a significant role to play, including sports injuries, infectious diseases, inflammatory and degenerative conditions, congenital and developmental disorders, acute trauma of bone and joints, and peripheral nerve injuries. In some circumstances, US can be regarded as the most effective means of diagnostic imaging, whereas in other instances, it is an alternative or supplement to other more comprehensive imaging modalities, like MRI and CT. Although MRI offers superior soft-tissue contrast resolution, US is low-cost, non-invasive and has higher spatial resolution and real-time capability for the assessment of musculoskeletal structures during joint movement and stress manoeuvres.Keywords Ultrasound . Musculoskeletal system . Trauma . Child High-resolution US is particularly well suited to examine the paediatric musculoskeletal system. An exquisite depiction of the immature skeleton and soft tissues can be obtained in a well-tolerated and non-invasive way without using ionising radiation or sedation. Although US has been widely used in the diagnosis of hip disorders in children, many other applications for US of the paediatric musculoskeletal system have been developed [1,2]. Over other imaging techniques, US is ideally suited for the evaluation of tendons, muscles, joints, ligaments and nerves. In addition, it may provide specific information on bone and cartilage. In this article, we review the use of US in a variety of musculoskeletal applications beyond the hip, including sports injuries, infectious diseases, inflammatory and degenerative conditions, congenital and developmental disorders, acute trauma of bone and joints, and peripheral nerve injuries. Sports-related injuries Apophyseal injuriesIn children and adolescents, apophyseal injuries are commonly related to sporting and recreational activities. Especially in the age range between 12 and 16 years, the ossification centres of most apophyses are still immature and the cartilage, under hormonal influence, loses elasticity and is unable to give firm stability to the osteotendinous junction. Hence, the rough shear or torsion forces exercised upon them by tendons and ligaments can overcome the threshold of cartilage and bone resistance causing fragmenDisclaimer The supplement this article is part of is not sponsored by the industry. Dr.

show abstract

Avulsion Injuries of the Pelvis

Cited by 83 publications

References 34 publications

Avulsion Fracture of the Anterior Inferior Iliac Spine among Amateur Football Players

Avulsion Fracture of the Anterior Inferior Iliac Spine among Amateur Football Players

Avulsion fracture of the lesser trochanter: an unusual cause of hip pain in an adolescent

Paediatric musculoskeletal US beyond the hip joint

Contact Info

Product

Resources

About