Pelvic and Hip Apophyseal Avulsion Injuries in Young Athletes

Abstract

Hip apophyseal injuries in young athletes are a fairly rare problem, and often go unrecognized by health professionals. These injuries can be extremely painful, and may take months to heal. Timely, accurate diagnosis is imperative so proper treatment can be initiated. In some cases, surgery is required.

Avulsion Fracture of the Iliac Crest Apophysis Treated With Open Reduction and Internal Fixation

“…They are more frequently reported now than in the past. 1,2 This may be the result of increased participation of adolescents in sports activities, advanced imaging techniques, and improved understanding of these injuries by the medical professionals. The possible locations of injuries include the anterior superior iliac spine, anterior inferior iliac spine, ischial tuberosity, symphysis pubis, iliac crest, greater trochanter, and lesser trochanter.…”

“…Displacement of avulsed apophyses is usually minimal because of the surrounding fascia and periosteum so nonoperative management with a guided rehabilitation program is generally considered the treatment of choice. 1,2,4 However, there also exists the possibility of complications with nonoperative treatment. A displacement of 2 to 3 cm has been recommended by some authors as indicating the need for surgical intervention.…”

“…[3][4][5][6][7][8][9][10][11] The patients in all the articles were treated nonoperatively. Although many authors suggested 3 cm displacement as an indication for operative treatment, 2,7,8,10,11 no one has reported an operatively managed case to date. The case presented here included initial displacement of greater than 3 cm and complete displacement out of the pelvic ring of the fractured apophysis.…”

Anterior inferior iliac spine avulsion fracture: a case report in soccer playing adolescent twins

“…Very high traction forces on the spine can logically lead to its avulsion. Pelvis apophyseal avulsion in adolescent has been well described as the consequence of a high stress as a result of violent muscle contraction [4,8,11,[19][20][21][22][23][24]. Rossi [3] showed that among pelvis avulsion fractures, AIIS frequency comes second just after ischiatic tuberosity.…”

Sports Specific Injuries of the Hip Joint

“…9.12a ) and the AIIS (Fig. 9.12b ) are the commonest avulsed apophyses, due to avulsion of the hamstrings and direct head of the rectus femoris, respectively [ 96 ]. Severe complications following avulsion injuries are rare, with femoral head necrosis reported after greater trochanteric avulsion [ 97 ].…”