Skeletal Radiology

, Volume 23, Issue 2, pp 85–90 | Cite as

Avulsion fractures of the pelvis in children: a report of 32 fractures and their outcome

  • Manthravadi Sundar
  • Helen Carty
Articles

Abstract

Avulsion injuries of the apophyses of the pelvis are mainly athletic injuries and are usually seen in adolescents. In a series of 80 pelvic fractures in children seen and managed in The Royal Liverpool Children's Hospital, Alder Hey, in the last 10 years, 32 avulsion fractures in 25 patients were diagnosed and treated. Twenty-two of these patients were followed for an average of 44 months (range 4–120 months). Eight (33%) were girls, a higher proportion than in other published series. The average age of the children was 13.8 years. These fractures, though generally regarded as trivial injuries, have left disability persisting into adult life, with limitation of sporting ability in 10 of the 22 patients and persistent symptoms in 6, mostly in those with ischial avulsion injuries. Fourteen patients with acute injuries needed hospitalisation, with an average stay of 5 days. The other 11 were suffering from chronic traction injuries sustained in sport. This distinction between acute and chronic injuries has not been emphasized in the other reviews. The radiological appearances, diagnostic problems and morbidity are discussed in order to increase awareness of these injuries.

Key words

Avulsion fractures Sports injury Chronic traction injury 

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References

  1. 1.
    Abbate C (1945) Avulsion fracture of the ischial tuberosity. J Bone Joint Surg 27:716Google Scholar
  2. 2.
    Berry JM (1912) Fracture of the tuberosity of the ischium due to muscular action. JAMA 59:1450Google Scholar
  3. 3.
    Carp L (1924) Fracture of the anterior superior spine of the ilium. Ann Surg 79:551Google Scholar
  4. 4.
    Christopher H (1933) Fracture of the anterior superior spine of the ilium. JAMA 100:113Google Scholar
  5. 5.
    Cohen HH (1937) Avulsion fracture of the ischial tuberosity. J Bone Joint Surg 19:1138Google Scholar
  6. 6.
    Curry JD, Butler G (1975) Mechanical properties of bone tissue in children. J Bone Joint Surg [Am] 57:810Google Scholar
  7. 7.
    Fernback SK, Wilkinson HR (1981) Avulsion injuries of pelvis and proximal femur. Am J Roentgenol 137:581Google Scholar
  8. 8.
    Gallagher JR (1935) Fracture of the anterior inferior spine of the ilium. Ann Surg 102:86Google Scholar
  9. 9.
    Hamsa WR (1957) Epiphyseal injuries about the hip joint. Clin Orthop 10:119Google Scholar
  10. 10.
    Irving MH (1964) Exostosis formation after traumatic avulsion of the anterior inferior iliac spine. J Bone Joint Surg [Br] 46:720Google Scholar
  11. 11.
    Kelly J (1963) Ischial epiphysitis. J Bone Joint Surg [Am] 45:435Google Scholar
  12. 12.
    Macleod S, Lewin P (1929) Avulsion of the tuberosity of the ischium. JAMA 92:1597Google Scholar
  13. 13.
    Martin TA, Pipkin G (1957) Treatment of avulsion of the ischial tuberosity. Clin Orthop 10:108Google Scholar
  14. 14.
    Metzmaker JN, Pappas AM (1980) Avulsion fractures of the pelvis. Orthop Trans 4:52Google Scholar
  15. 15.
    Milch H (1926) Avulsion fracture of the tuberosity of ischium. J Bone Joint Surg 8:832Google Scholar
  16. 16.
    Robertson RC (1935) Fracture of the anterior superior spine of the ilium. J Bone Joint Surg 17:1045Google Scholar
  17. 17.
    Rogge E, Romano RL (1956) Avulsion of the ischial apophysis. J Bone Joint Surg [Am] 38:442Google Scholar
  18. 18.
    Rush LV, Rush HL (1939) Avulsion of the anterior superior spine of the ilium. J Bone Joint Surg 21:206Google Scholar
  19. 19.
    Schlonsky J, Olix ML (1972) Functional disability following avulsion fracture of the ischial epiphysis. J Bone Joint Surg [Am] 54:641Google Scholar
  20. 20.
    Watts HG (1976) Fractures of pelvis in children. Orthop Clin North Am 7:615Google Scholar
  21. 21.
    Winkler AR, Barnes JC, Ogden JA (1987) Break dance hip: chronic avulsion of the anterior superior iliac spine. Pediatr Radiol 17:501Google Scholar

Copyright information

© International Skeletal Society 1994

Authors and Affiliations

  • Manthravadi Sundar
    • 1
  • Helen Carty
    • 2
  1. 1.Department of OrthopaedicsRoyal Liverpool Children's NHS TrustLiverpoolUK
  2. 2.Department of RadiologyRLC NHS TrustAlder Hey, LiverpoolUK

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