Skip to main content

Advertisement

Log in

Comparison of conservative against surgical treatment of anterior–superior iliac spine avulsion fractures in children and adolescents

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

Avulsion fracture of the anterior–superior iliac spine is an uncommon injury. It is mostly seen in adolescent sprinters, distance runners and soccer players. Most cases are unilateral. We present a cohort of patients and the strategy for their treatment.

Methods

During the period 2005–2012, we treated 23 (19 male, four female) patients with an average age of 15.1 years (4–17). Ten patients with minimally displaced fractures were treated conservatively, and 13 patients with greater fragment dislocation were treated surgically. All patients underwent the standardised rehabilitation protocol. We evaluated range of motion (ROM), X-ray six weeks and one year postoperatively, length of bed rest, return to activity and complication rates (infection, heterotopic ossification).

Results

All patients returned to sports at the preinjury level. Surgically treated patients showed faster recovery and better compliance with rehabilitation protocols. The time interval for X-ray union was comparable between groups, as was full recovery. There was no deep infection; however, there were five minor heterotopic ossifications, none of which required further treatment.

Conclusion

We emphasise that the indication for surgical treatment is mainly determined by the grade of fragment displacement and the patient’s sporting activity. Although long-term results were comparable between treatment methods, surgery carries the risk of higher complication rates and the need for osteosynthetic material extraction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Rossi F, Dragoni S (2001) Acute avulsion fractures of the pelvis in adolescent competitive athletes: prevalence, location and sports distribution of 203 cases collected. Skeletal Radiol 30(3):127–131

    Article  CAS  PubMed  Google Scholar 

  2. Hansson PG (1970) Bilateral avulsion fracture of the anterior superior iliac spine. Acta Chir Scand 136:85–86

    CAS  PubMed  Google Scholar 

  3. Rosenberg N, Noiman M, Edelson G (1996) Avulsions fractures of the anterior superior iliac spine in adolescents. J Orthop Trauma 10:440–443

    Article  CAS  PubMed  Google Scholar 

  4. Pointinger H, Munk P, Poeschl GP (2003) Avulsion fracture of the anterior superior iliac spine following apophysitis. Br J Sports Med 37:361–362

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Havlas V, Gaheer RS, Trc T, Anwar F (2007) Simultaneous bilateral avulsion fracture of the anterior superior iliac spine in a young athlete. Inj Extra 38(10):352–355

    Article  Google Scholar 

  6. Bendeddouche I, Jean-Luc BB, Poiraudeau S, Nys A (2010) Anterior superior iliac spine avulsion in a young soccer player. Ann Phys Rehabil Med 53:584–590

    Article  CAS  PubMed  Google Scholar 

  7. Tchanikachalam M, Petros JG, O’Donnell S (1995) Avulsion fracture of anterior superior iliac spine presenting as acute-onset meralgia paresthetica. Ann Emerg Med 26:515–517

    Article  Google Scholar 

  8. Oldenburg FP, Smith MV, Thompson GH (2009) Simultaneous ipsilateral avulsion of the anterior superior and anterior inferior iliac spines in an adolescent. J Pediatr Orthop 29:29–30

    Article  PubMed  Google Scholar 

  9. Risser JC (1977) Iliac apophysis. Clin Orthop 122:366

    Article  PubMed  Google Scholar 

  10. Naylor JA, Goffar SL, Chugg J (2013) Avulsion fracture of the anterior superior iliac spine. J Orthop Sports Phys Ther 43:195

    Article  PubMed  Google Scholar 

  11. Dhinsa BS, Jalgaonkar A, Mann B, Butt S, Pollock R (2011) Avulsion fracture of the anterior superior iliac spine: misdiagnosis of a bone tumour. J Orthop Traumatol 12:173–176

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

Supported by Czech Research Institution Grant Project No. 00064203.

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vojtech Havlas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kautzner, J., Trc, T. & Havlas, V. Comparison of conservative against surgical treatment of anterior–superior iliac spine avulsion fractures in children and adolescents. International Orthopaedics (SICOT) 38, 1495–1498 (2014). https://doi.org/10.1007/s00264-014-2323-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-014-2323-0

Keywords

Navigation