Apophyseal avulsion fractures of the pelvis and hip

Apophyseal avulsion fractures of the pelvis and hip are relatively common among physically active adolescents and young adults.

Epidemiology

Pelvic and hip apophyseal injuries typically occur in the 14 to 25 year age range.

Mechanism

Kicking sports, such as soccer, and gymnastics are frequently implicated.

Pathology

Sudden forceful muscular contraction causes avulsion of the apophysis to which the tendon attaches.

Sites of avulsion

• iliac crest: anterior abdominal wall muscles
• anterior superior iliac spine: tensor fascia lata and sartorius
• anterior inferior iliac spine: straight head of rectus femoris
• greater trochanter: gluteus medius and gluteus minimus
• lesser trochanter: iliopsoas muscle
• ischial tuberosity: hamstring muscles
• body and inferior ramus of pubis: thigh adductors and gracilis

See also

• avulsion injuries