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Sports Medicine

, Volume 16, Issue 4, pp 290–294 | Cite as

Ischial Apophysis Injuries in Athletes

  • Urho M. Kujala
  • Sakari Orava
Injury Clinic

Summary

The diagnosis and treatment of ischial tuberosity pain in athletes include several clinical entities. These injuries include apophysitis, adult tug lesion, painful unfused apophysis, and acute and old avulsions. In some avulsion injuries a bony fragment can be seen, but they can also be x-ray-negative, especially in children. An insertional tendon rupture is also possible. Conservative treatment of apophysitis includes modification of activities and anti-inflammatory medication. Avulsions, if diagnosed early, usually heal with conservative therapy, especially if the displacement is not marked. Urgent surgical treatment is recommended in cases with total or nearly total soft-tissue hamstring muscle insertion rupture. Surgery has to be considered also in cases with dislocation of the apophysis or bony avulsion of more than 2cm. Excision of the excessive mass or poorly united fragment provides relief of pain in some cases of old avulsions.

Keywords

Avulsion Fracture Stress Injury Hamstring Muscle Ischial Tuberosity Bony Fragment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Abbate CC. Avulsion fracture of the ischial tuberosity: a case report. Journal of Bone and Joint Surgery 27: 716–717, 1945Google Scholar
  2. Barnes ST, Hinds RB. Pseudotumor of the ischium: a late manifestation of avulsion of the ischial epiphysis. Journal of Bone and Joint Surgery — American Volume 54: 645–647, 1972Google Scholar
  3. Berry JM. Fracture of the tuberosity of the ischium due to muscular action. Journal of the American Medical Association 59: 1450, 1912CrossRefGoogle Scholar
  4. Fernbach SK, Wilkinson RH. Avulsion injuries of the pelvis and proximal femur. American Journal of Roentgenology 137: 581–584, 1981PubMedGoogle Scholar
  5. Hamada G, Rida A. Ischial apophysiolysis (IAL): report of a case and a review of the literature. Clinical Orthopaedics and Related Research 31: 117–130, 1963PubMedCrossRefGoogle Scholar
  6. Howard FM, Piha RJ. Fractures of the apophyses in adolescent athletes. Journal of the American Medical Association 192: 842–844, 1965PubMedCrossRefGoogle Scholar
  7. Hulkko A. Stress fractures in athletes. A clinical study of 368 cases, Thesis, University of Oulu, Finland, 1988Google Scholar
  8. Keats TE. Radiology of musculoskeletal stress injury, pp. 52–61, Year Book Medical Publishing Inc., Chicago, 1990Google Scholar
  9. Kozlowski K, Campbell JB, Azouz EM. Traumatized ischial apophysis (report of six cases). Australasian Radiology 33: 140–143, 1989PubMedCrossRefGoogle Scholar
  10. Kujala UM, Kvist M, Heinonen O. Osgood-Schlatter’s disease in adolescent athletes. Retrospective study of incidence and duration. American Journal of Sports Medicine 13: 236–241, 1985PubMedCrossRefGoogle Scholar
  11. Labuz EF. Avulsion of the ischial tuberosity: report of a case. Journal of Bone and Joint Surgery 28: 388–389, 1946PubMedGoogle Scholar
  12. Martin TA, Pipkin G. Treatment of avulsion of the ischial tuberosity. Clinical Orthopaedics and Related Research 10: 108–118, 1957Google Scholar
  13. Milch H. Avulsion fracture of the tuberosity of the ischium. Journal of Bone and Joint Surgery 8: 832–838, 1926Google Scholar
  14. Milch H. Ischial apophysiolysis — a new syndrome. Clinical Orthopaedics and Related Research 2: 184–193, 1953Google Scholar
  15. Puranen J, Orava S. The hamstring syndrome. A new diagnosis of gluteal sciatic pain. American Journal of Sports Medicine 16: 517–521, 1988PubMedCrossRefGoogle Scholar
  16. Rich BS, McKeag D. When sciatica is not a disk disease. Detecting piriformis syndrome in active patients. Physician and Sportsmedicine 20: 105–115, 1992Google Scholar
  17. Schlonsky J, Olix ML. Functional disability following avulsion fracture of the ischial epiphysis: report of two cases. Journal of Bone and Joint Surgery — American Volume 54: 641–644, 1972Google Scholar
  18. Schuhmacher B, Hudler J, Steinbruck K. Abriss des proximalen Ansatzes des Musculus biceps femoris. 2: Fallberichte. Deutsche Zeitschrift fur Sportmedizin 42: 593–596, 1991Google Scholar
  19. Schwab SA. Epiphyseal injuries in the growing athlete. Canadian Medical Association Journal 117: 626–630, 1977PubMedGoogle Scholar
  20. Wootton JR, Cross MJ, Holt KWG. Avulsion of the ischial apophysis. Journal of Bone and Joint Surgery — British Volume 72: 625–627, 1990Google Scholar
  21. Wuschech H, Lehnigh P, Ahrendt E. Seltene Sportverlezungen bei jugendlichen Sportlern. Medizin und Sport 9: 186–188, 1969Google Scholar

Copyright information

© Adis International Limited 1993

Authors and Affiliations

  • Urho M. Kujala
    • 1
  • Sakari Orava
    • 2
  1. 1.Helsinki Research Institute for Sports and Exercise Medicine, Toolon kisahalliHelsinkiFinland
  2. 2.Hospital MeditoriTurkuFinland

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