Missed Avulsion Fracture of the Ischial Tuberosity in an Adolescent Competitive Athlete: Case Report and Literature Review

Pilichou, Anastasia; Sekouris, Nick; Nikolaou, Vasilios; Demetriou, Evangelos; Angoules, Antonios G; Tsivgoulis, Stilianos; Vlachos, Eugene

doi:10.4172/2167-1222.s2-002

Cited by 6 publications

(15 citation statements)

References 22 publications

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“…Eight months after the operation, the patient completely recovered to the level of exercise before injury. Most authors [2,8] support exercise starting 2 weeks after surgery and suggest fixation of orthosis for 4 to 6 weeks, while others [11] recommend that patients sit on the 1st day of surgery and do not suggest orthosis protection. We believe this could be detrimental.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment for acute ischial tuberosity avulsion fracture

Liu

Shi

et al. 2019

Medicine

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Rationale: Ischial tuberosity avulsion fracture (ITAF) is a very rare sports injury, and there is currently no consensus on its diagnosis and treatment. Although conservative treatment is adequate for most patients, those with large displacement of the fracture need surgical management. Patient concerns: A 13-year-old male athlete experienced tearing pain in the right hip during a sprint. Radiographic examination showed an avulsion fracture of the right ischial tuberosity. Diagnosis: Right ITAF. Interventions: On the 3rd day of injury, the patient was treated with open reduction and internal fixation of ITAF under general anesthesia. Outcomes: The patient received a systematic postoperative exercise in 2 weeks, and the fracture healed 4 weeks later. After 8 months, the patient returned to the field to participate in the competition. Lessons: Early surgical treatment can bring about good results in the treatment of ITAF with large displacement. The longitudinal incision and subgluteal approach is an ideal choice for the operative procedure.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment for acute ischial tuberosity avulsion fracture

Liu

Shi

et al. 2019

Medicine

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“…AFIT is closely associated with competitive sports, such as football and track and field [15,16]. However, ischial tuberosity damage can also be caused by long-term chronic strain, such as ischial tuberculosis [16], and this disorder can be further developed to avulsion fracture.…”

Section: Mechanism Of Injurymentioning

confidence: 99%

“…It can detect occult fractures of the AFIT through the edema-like signal intensity of the ischial tuberosity and surrounding soft tissue, and the amount of subperiosteal fluid [22] (Figure 2D). Some investigators [15] have considered that ultrasound is also a useful diagnostic tool that can be used to identify whether nerve damage is present. However, the investigators in the present study consider that ultrasound was not as good as MRI in the diagnosis of AFIT [23].…”

Section: Imaging Examinationmentioning

confidence: 99%

“…For the choice of surgical location, most investigators [15,39] selected the special position of prone, hip and knee flexion, which was considered conducive for the exposure of ischial tuberosity. However, other investigators [14] preferred the lateral position.…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…Therefore, as mentioned earlier, the subgluteal surgical approach advocated by Saka et al [39] can also be a good choice for the advanced surgery for AFIT. Regarding the choice of surgical procedure, Pilichou et al [15] chose to remove the fibrous tissue surrounding the avulsed fracture block, and reset the bone mass. Sikka et al [27] chose to directly remove the avulsion fracture block, and use the bone anchor to reattach the hamstring tendon to the ischial tuberosity.…”

Section: Surgical Treatmentmentioning

confidence: 99%

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Avulsion Fractures of the Ischial Tuberosity: Progress of Injury, Mechanism, Clinical Manifestations, Imaging Examination, Diagnosis and Differential Diagnosis and Treatment

et al. 2018

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Avulsion fracture of the ischial tuberosity (AFIT) is a rare adolescent sports injury. At present, there is no consensus on its therapeutic paradigm, but conservative treatment appears to be the predominate choice. Furthermore, the degree of fracture displacement (DFD) remains as an important factor in determining whether AFIT needs internal fixation. The aim of the present study was to review and update the injury mechanism, clinical manifestations, imaging examination, diagnosis and differential diagnosis, and treatment of AFIT.A literature search was performed on a variety of databases using text words, and the results were limited to the English language.This review provides an important reference for the diagnosis and treatment of AFIT.AFIT can be easily misdiagnosed. Therefore, a detailed medical history and imaging examination are crucial for a correct diagnosis and differential diagnosis. For the choice of treatment of AFIT, it is necessary to consider not only the size of the fracture and DFD, but also the long-term functional needs of the patient.

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Avulsion Injuries

Gänsslen¹,

Weinberg²

2020

Pelvic Ring Fractures

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Missed Avulsion Fracture of the Ischial Tuberosity in an Adolescent Competitive Athlete: Case Report and Literature Review

Cited by 6 publications

References 22 publications

Surgical treatment for acute ischial tuberosity avulsion fracture

Surgical treatment for acute ischial tuberosity avulsion fracture

Avulsion Fractures of the Ischial Tuberosity: Progress of Injury, Mechanism, Clinical Manifestations, Imaging Examination, Diagnosis and Differential Diagnosis and Treatment

Avulsion Injuries

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