Surgical fenestration and rehabilitation of a sports traumatic non-union ischial tuberosity fracture – Case report

Jørgensen, Jens-Erik; Mølgaard, Carsten; Kristinsson, Jens

doi:10.1016/j.ijscr.2018.11.018

Cited by 5 publications

(14 citation statements)

References 17 publications

(20 reference statements)

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“…Acute trauma during sporting activities was responsible for 74.4% (n = 67/90) of injuries [2][3][4]6,7,15,[17][18][19][20][22][23][24][25][26][27]29,31,32,[34][35][36][37][38][39][40], with the most commonly reported mechanism of injury involving an excessive eccentric force placed across the proximal hamstring secondary to concurrent hip flexion and knee extension. Twenty-three cases of AFIT were reported as being chronic in nature secondary to either repetitive stress or an initial misdiagnoses resulting in delayed treatment [14,16,17,21,24,[28][29][30]33,35,41].…”

Section: Etiology and Mechanisms Of Injurymentioning

confidence: 99%

“…When reported, a high rate of misdiagnosis was found during initial presentation (39.4%, n = 28/71), most commonly with an isolated tendinous hamstring tear, prior to correct diagnosis and treatment [4,6,14,15,17,21,22,24,28,30,32,34,35,4 0]. The overall mean latency from initial injury to correct diagnosis and treatment was 42.7 + 83.2 weeks (median, 9 weeks) [2][3][4]7,[14][15][16][17][18][20][21][22][23][24][25][26][27][28]31,[33][34][35][37][38][39][40][41][42]. Of the [40], or K-wires (n = 2/38) [22,25].…”

Section: Etiology and Mechanisms Of Injurymentioning

confidence: 99%

“…The overall mean latency from initial injury to correct diagnosis and treatment was 42.7 + 83.2 weeks (median, 9 weeks) [2][3][4]7,[14][15][16][17][18][20][21][22][23][24][25][26][27][28]31,[33][34][35][37][38][39][40][41][42]. Of the [40], or K-wires (n = 2/38) [22,25]. Fixation technique was not reported in two patients from a single study [40].…”

Section: Etiology and Mechanisms Of Injurymentioning

confidence: 99%

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Avulsion fractures of the ischial tuberosity in the pediatric athlete: a systematic review and return to sport analysis

Vadhera

Knapik²,

Gürsoy³

et al. 2022

Journal of Pediatric Orthopaedics B

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Apophyseal avulsion fractures of the ischial tuberosity (AFIT) in pediatric athletes are relatively uncommon injuries with treatment and return to sport (RTS) outcomes being largely unknown. The purpose of this review is to perform a systematic review analyzing RTS and predictors of successful RTS for pediatric athletes sustaining AFIT. Studies reporting on athletes strictly under the age of 18 years sustaining an AFIT with reported RTS status were included. RTS was analyzed based on injury acuity, mechanism, and management, whereas the incidence of any complications was recorded. A total of 33 studies comprising 90 cases of AFIT were identified. The mean age of athletes sustaining injuries was 14.7 + 1.4 years (range, 9–17 years), most commonly participating in soccer (n = 25), sprinting (n = 21), and gymnastics (n = 7). Acute trauma during sporting activities was responsible for 74.4% (n = 77/90) of injuries. A total of 82% (n = 74/90) of athletes reported successful RTS at an average of 7.0 + 5.0 months. Athletes undergoing surgery had a significantly higher RTS rate (n = 36/38, 94.7%) compared with athletes treated nonoperatively (n = 38/52, 73.08%; P = 0.008). When reported, a high rate of misdiagnosis was reported (39.4%, n = 28/71). Complications were reported in 15.8% (n = 7/38) and 32.7% (n = 17/52) of athletes managed surgically and conservatively, respectively. As such, the high rate of misdiagnosis and subsequent high rate of complications and poor rate of RTS highlight the importance of accurate diagnosis and treatment. Future prospective studies evaluating patient outcomes based on fracture displacement, sporting activity, and management strategies are warranted to better treat pediatric athletes. Study design: Level IV, systematic review.

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Section: Etiology and Mechanisms Of Injurymentioning

confidence: 99%

Section: Etiology and Mechanisms Of Injurymentioning

confidence: 99%

Section: Etiology and Mechanisms Of Injurymentioning

confidence: 99%

See 1 more Smart Citation

Avulsion fractures of the ischial tuberosity in the pediatric athlete: a systematic review and return to sport analysis

Vadhera

Knapik²,

Gürsoy³

et al. 2022

Journal of Pediatric Orthopaedics B

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“…The rarity of this report lies in the surgical method for treating the ischial tuberosity avulsion fracture with nonunion. Other reported procedures are plate fixation [10], bone transplantation [6], repair of the hamstring tendon with suture anchors after fragment excision [5], and surgical fenestration [4,11]. We applied cancellous screws and suture anchors to fix the bone fragment, which led to the bony union.…”

Section: Case Reports In Orthopedicsmentioning

confidence: 99%

Surgically Treated Nonunion following Ischial Tuberosity Avulsion Fracture of a 14-Year-Old Athlete

Nakamatsu

Fukui

et al. 2020

Case Reports in Orthopedics

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A 14-year-old girl experienced acute left buttock pain during a sprint. At the local hospital, she was diagnosed with an avulsion fracture of the left ischial tuberosity. She was kept for observation for about 10 months; however, the buttock pain persisted, and the bone fragments did not unite. She was referred to our hospital approximately 11 months after the injury. Plain radiography revealed an increased transposition of the bone fragment, from 12 mm immediately after the injury to 23 mm. Twelve months after the injury, she underwent osteosynthesis using two cannulated cancellous screws and three suture anchors. Following postoperative rehabilitation, the power in her left hamstring recovered, and she was able to run at full speed and returned to athletics 9 months after the surgery. The operative indications for avulsion fractures of the ischial tuberosity are unclear. Careful follow-up is required as the rate of nonunion after conservative treatment tends to be high. This needs to be identified in order to provide timely treatment that allows for early return to sport. Although she had significant chronic pain and muscle weakness, the surgery successfully treated the fracture, and her muscle power recovered, leading to her return to sports.

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“…There are multiple choices of surgical techniques and fixation methods for the treatment of BAIT, such as cancellous screw fixation, cannulated screw fixation, 4 suture anchor fixation, 5 plate fixation, 6 and excision of the fragment and refixation [1][2][3]6,7 or just fenestration. 8 This article presents a Technical Note for osteosynthesis of BAIT (Video 1). The strengths and weaknesses of this surgical technique are presented in Table 1, and technical tricks are presented in Table 2.…”

mentioning

confidence: 99%

Treatment of Acute Bony Avulsion of Ischial Tuberosity With Cortical Screw Fixation

Sezer

Hardy

Bohu

et al. 2021

Arthroscopy Techniques

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Surgical fenestration and rehabilitation of a sports traumatic non-union ischial tuberosity fracture – Case report

Cited by 5 publications

References 17 publications

Avulsion fractures of the ischial tuberosity in the pediatric athlete: a systematic review and return to sport analysis

Avulsion fractures of the ischial tuberosity in the pediatric athlete: a systematic review and return to sport analysis

Surgically Treated Nonunion following Ischial Tuberosity Avulsion Fracture of a 14-Year-Old Athlete

Treatment of Acute Bony Avulsion of Ischial Tuberosity With Cortical Screw Fixation

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