Avulsion Fractures Around The Hip In Adolescence - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the condition of Avulsion Fractures around the Hip in adolescence.
Avulsion fractures of the hip and pelvis in adolescence are not uncommon. Several avulsion fractures can occur around the hip and pelvis due to strong pull of these muscles.
These are the five most likely sites to become avulsed:
1-Iliopsoas.
2-Gluteus medius and minimus
3-Sartorius
4-Rectus femoris
5-Hamstrings
Avulsion fractures usually occur in young athletic adolescences. The patient may feel a pop with pain, weakness and be unable to walk.
Avulsion of the distal iliopsoas tendon occurs at its insertion into the lesser trochanter of the femur. Isolated avulsion fractures of the lesser trochanter in older patients are usually pathological. Avulsion of the iliopsoas tendon is an uncommon injury that occurs more in adolescents due to athletic activity.
Bony avulsion of the gluteus medius and minimus tendons may occur at their insertion into the greater trochanter of the femur and probably needs surgery.
Bony avulsion of the sartorius tendon occurs from a strong pull of the sartorius with the hip in extension and the knee in flexion. Avulsion of the sartorius from its attachment site most commonly occurs in sprinters and other running athletes. Avulsion of the anterior superior iliac spine can occur in adults form bone graft harvesting.
Avulsion of the rectus femoris origin is a rare injury. With a rectus femoris avulsion fracture, the fragment is usually pulled and lies close to the hip joint, An X-ray will usually show the fragment close to the hip joint.
Injury of the proximal hamstring usually occurs in athletes and can result in an avulsion fracture of the ischium. These avulsion injuries are not common and usually occur in patients who are younger, skeletally immature athletes.
Treatment
•Ice
•Decreased activity with rest
•Crutches
•Weight-bearing as tolerated
•Nonweight bearing
•Surgery may be indicated in the severe displacement of a large bony fragment or in case of a painful nonunion.

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