Traumatic unilateral avulsion of the anterior superior and inferior iliac spines with anterior dislocation of the hip: a case report

Atypical anterior wall fracture extending to anterior inferior iliac spine with preservation of pelvic brim: A case report and literature review

Key Clinical Message

Anterior acetabular wall fractures that extend into the anterior inferior iliac spine are more likely to be unstable, and more likely to require surgical fixation.

Abstract

Conventional acetabular anterior wall fractures originate below the anterior inferior iliac spine (AIIS) level and involve the pelvic brim. Since surgical treatment is preserved for instability and hip incongruency, atypical variation of this fracture usually jeopardizes hip stability. We report on a 33-year-old case of an acetabular anterior wall fracture extending to the anterior inferior iliac spine. He was prepared for the stress test and hip stability checked, that was unstable in extension and external rotation. The joint was exposed with the Smith-Peterson approach. Hip congruency was restored, and the AIIS fragment was stabilized by open reduction. Acetabular anterior wall fracture involving AIIS with preservation of pelvic brim is a rare equivalent of anterior wall fracture that jeopardizes hip stability and should be managed surgically. Anterior approaches are preferred in order to visualize the joint.

Iliac Crest Avulsion Fracture in a Young Sprinter

Avulsion fracture of the iliac crest is an uncommon pathology. It usually occurs in teenagers during sport activities, more common in boys. We report a case of 16-year-old male competitive sprinter, who had an avulsion of a part of the iliac crest and the anterior-superior iliac spine during a competition. The traumatism occurred during the period of acceleration phase out of the blocks which corresponds to the maximum traction phase on the tendons. Then a total loss of function of the lower limb appears forcing him to stop the run. X-ray and CT scan confirmed the rare diagnosis of avulsion of the quasitotality of the iliac crest apophysis, corresponding to Salter 2 fracture. We performed an open reduction and internal fixation with two screws, allowing a return to sport after 3 months and his personal best record in the 100 meters at the 6th postoperative month.

Anterior superior iliac spine avulsion in a young soccer player

Avulsion fractures of the anterior superior iliac spine are rare. They usually occur in teenagers during sport activities. Cases concerning adults are very uncommon. We report here the case of a 23-year-old man who was admitted for recent pain of the left hip that worsened while kicking a ball in a soccer match eight days earlier. The examination found pain when moving the left hip in extension. Radiographs showed an avulsion fracture of the left anterior superior iliac spine, which was confirmed by computer tomography. The treatment was conservative consisting in rest and non-weight bearing with releasing of pain a few weeks later.

Anterior inferior iliac spine avulsion fracture: a case report in soccer playing adolescent twins

A case of anterior inferior iliac spine fracture in 13-year-old twins is reported. Anterior inferior iliac spine avulsion fracture in adolescent remains a little known entity. We report identical fractures sustained 1 year apart in twin brothers with the same mechanism. Both recovered fully after conservative treatment. A review of the literature retrieved only a few reports of cases. Of interest were the delay between both the fractures and the difference in height between the two individuals. This lesion is likely to be multifactorial with different factors among which are genetics, age, and skeletal maturation, repeat bone stress along with acute indirect trauma.

Bilateral anterior inferior iliac spine avulsion in an adolescent soccer player: a typical imitator of malignant bone lesions

Avulsion fractures are usually diagnosed easily in acutely presented cases. The diagnosis becomes definite if clinical and radiological follow up reflect the fracture's healing phase. A 13-year-old soccer player with bilateral anterior inferior iliac spine (AIIS) avulsion, who had been examined in other institutions with a prediagnosis of malignancy, is reported. Clinically, such cases display the importance of medical management of athletic injuries by specially trained physicians. From the perspective of preventive medicine, the high incidence of AIIS injuries during soccer games, and the bilateral nature of the damage mandate a review of the training programs and shooting techniques for adolescent players.

Simultaneous ipsilateral avulsion of the anterior superior and anterior inferior iliac spines in an adolescent

BACKGROUND

Only one case of simultaneous avulsion fractures of the anterior superior and anterior inferior iliac spines has been previously reported. This was associated with a hip dislocation.

METHODS

A 16-year-old male adolescent sustained ipsilateral avulsion fractures of his superior and inferior iliac spines from a hyperextension injury of his right hip in a skiing accident. He healed satisfactorily after nonoperative treatment with protected weight bearing and limited active hip range of motion.

RESULTS

The patient healed in 12 weeks and returned to full activities, including sports, without complications.

CONCLUSIONS

Conservative treatment of simultaneous ipsilateral avulsion fractures of the anterior superior and anterior inferior iliac spines can lead to a good outcome.

Apophyseal avulsion fractures of the hip and pelvis

Apophyseal avulsion fractures of the hip and pelvis are infrequent pediatric fractures. However an increase of adolescent participation in competitive sporting activities and better musculoskeletal imaging techniques has led to an increased awareness of these injuries by the medical community. These fractures can be easily missed. When these fractures are diagnosed and treated appropriately, nonsurgical protocol has bee proposed in the literature. Surgical treatment is usually reserved for certain indications. Complications of these injuries include painful nonunion, exostosis, osteonecrosis, and mechanism of injury and treatment options, these fractures can be successfully diagnosed and treated.

Traumatic anterior dislocation of the hip joint with fracture of the acetabulum: a case report

A 67-year-old woman sustained a pubic-type anterior dislocation of the hip associated with a comminuted fracture of the anterosuperior part of the acetabulum and the anteroinferior iliac spine following a fall on the knee. Because of interposition of the iliopsoas tendon, closed reduction followed by skeletal traction failed to achieve reduction of the acetabular fragment. An abnormally high degree of anteversion of the femoral neck is suggested as a possible predisposing factor in this injury.