Pelvic Apophyseal Avulsion Fractures

Schuett, Dustin J.; Bomar, James D.; Pennock, Andrew T.

doi:10.1097/bpo.0000000000000328

Cited by 105 publications

(78 citation statements)

References 23 publications

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“…Due to these promising results, authors increasingly propose surgical treatment of apophyseal fractures [1, 5, 7, 10, 12, 22, 24, 31]. The results of the present study support these recommendations.…”

Section: Discussionsupporting

confidence: 81%

“…Out of 667 articles identified through the initial search and 5 additional records detected through the reference lists, a total of 14 studies met the inclusion criteria [3, 5, 7, 8, 10–12, 21–27]. The flow diagram according to PRISMA guidelines summarizes the selection protocol (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Apophyseal avulsion fractures of the pelvis are rare injuries that typically occur in the adolescent athlete [10, 28]. Awareness of these injuries increased over the past few years due to better musculoskeletal imaging techniques and a growing participation of adolescent athletes in competitive sporting activities [1].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical examination reveals local tenderness, limitation of motion, and swelling [6, 7]. The apophyses may fracture at the rectus femoris insertion at the anterior inferior iliac spine (AIIS), the hamstrings insertion at the ischial tuberosity (IT), the sartorius insertion at the anterior superior iliac spine (ASIS), the tensor fasciae latae insertion on the iliac crest (IC), the iliopsoas insertion on the lesser trochanter (LT), or the rectus abdominis insertion at the superior corner of the pubic symphysis (SCPS) [8–10]. Historically, most of the pelvic avulsion fractures have been treated nonoperatively including analgetics, bed rest, immobilization of the affected muscle group, and physical rehabilitation [11].…”

Section: Introductionmentioning

confidence: 99%

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Operative versus conservative treatment of apophyseal avulsion fractures of the pelvis in the adolescents: a systematical review with meta-analysis of clinical outcome and return to sports

Eberbach

Hohloch

Feucht

et al. 2017

BMC Musculoskelet Disord

116

128

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BackgroundAvulsion fractures of the pelvic apophyses typically occur in adolescent athletes due to a sudden strong muscle contraction while growth plates are still open. The main goals of this systematic review with meta-analysis were to summarize the evidence on clinical outcome and determine the rate of return to sports after conservative versus operative treatment of avulsion fractures of the pelvis.MethodsA systematic search of the Ovid database was performed in December 2016 to identify all published articles reporting outcome and return to preinjury sport-level after conservative or operative treatment of avulsion fractures of the pelvis in adolescent patients. Included studies were abstracted regarding study characteristics, patient demographics and outcome measures. The methodological quality of the studies was assessed with the Coleman Methodology Score (CMS).ResultsFourteen studies with a total of 596 patients met the inclusion criteria. The mean patient age was 14.3 ± 0.6 years and 75.5% of patients were male. Affected were the anterior inferior iliac spine (33.2%), ischial tuberosity (29.7%), anterior superior iliac spine (27.9%), iliac crest (6.7%) lesser trochanter (1.8%) and superior corner of the pubic symphysis (1.2%). Mean follow-up was 12.4 ± 11.7 months and most of the patients underwent a conservative treatment (89.6%). The overall success rate was higher in the patients receiving surgery (88%) compared to the patients receiving conservative treatment (79%) (p = 0,09). The rate of return to sports was 80% in conservative and 92% in operative treated patients (p = 0,03). Overall, the methodological quality of the included studies was low, with a mean CMS of 41.2.ConclusionOn the basis of the present meta-analysis, the overall success and return to sports rate was higher in the patients receiving surgery. Especially in patients with fragment displacement greater 15 mm and high functional demands, surgical treatment should be considered.

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Section: Discussionsupporting

confidence: 81%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Operative versus conservative treatment of apophyseal avulsion fractures of the pelvis in the adolescents: a systematical review with meta-analysis of clinical outcome and return to sports

Eberbach

Hohloch

Feucht

et al. 2017

BMC Musculoskelet Disord

116

128

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“…72,81 Additionally, as the pubic symphysis is the last part of the human skeleton to mature, pubic apophysitis should be considered in the differential diagnosis of hip and groin pain in athletes as they age into their early twenties. 74 Adolescent athletes are also at increased risk of hip-related problems if they have a previous history of slipped capital femoral epiphysis, 18 Legg-Calvé-Perthes disease, 55 or acetabular dysplasia.…”

mentioning

confidence: 99%

Clinical Examination, Diagnostic Imaging, and Testing of Athletes With Groin Pain: An Evidence-Based Approach to Effective Management

Thorborg¹,

Reiman²,

Weir³

et al. 2018

Journal of Orthopaedic & Sports Physical Therapy

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[ clinical commentary ] U U SYNOPSIS: Groin pain is common in athletes who participate in multidirectional sports and has traditionally been considered a difficult problem to understand, diagnose, and manage. This may be due to sparse historical focus on this complex region in sports medicine. Until recently, there has been little agreement regarding terminology, definitions, and classification of groin pain in athletes. This has made clear communication between clinicians difficult, and the results of research difficult to interpret and implement into practice. However, during the past decade, the field has evolved rapidly, and an evidence-based understanding is now emerging. This clinical commentary discusses the clinical examination (subjective history, screening, physical examination); imaging; testing of impairments, function, and performance; and management of athletes with groin pain in an evidence-based framework.

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Pediatric Pelvic Injuries

Kenawey

2019

The Pediatric and Adolescent Hip

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Pelvic Apophyseal Avulsion Fractures

Abstract: Level IV-therapeutic.

Cited by 105 publications

References 23 publications

Operative versus conservative treatment of apophyseal avulsion fractures of the pelvis in the adolescents: a systematical review with meta-analysis of clinical outcome and return to sports

Operative versus conservative treatment of apophyseal avulsion fractures of the pelvis in the adolescents: a systematical review with meta-analysis of clinical outcome and return to sports

Clinical Examination, Diagnostic Imaging, and Testing of Athletes With Groin Pain: An Evidence-Based Approach to Effective Management

Pediatric Pelvic Injuries

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