Avulsion Fracture of the ASIS

ASIS avulsion fracture in a 16 year old playing soccer. An uncommon injury, in adolescents, where the sartorius and/or Tensor Fascia Lata pulls suddenly on it's pelvic attachment, near the growth plate. Depending on the extent of displacement, either surgical or conservative management can be undertaken. Conservative treatment consisted of bed rest, with the affected hip at 70–90° flexion for the first three weeks, with symptomatic treatment of pain and soft-tissue oedema. After three weeks, physiotherapy and ambulation with crutches can begin, determined by X-ray findings. Partial weight bearing using crutches is indicated until six weeks from injury, when an X-ray check should be performed, and gradual full weight bearing with restricted running, jumping and sports are allowed Sprinting and full participation in sports activity was allowed six months after the injury.

Sartorius Muscle

Tensor Fascia Lata

Further, complications may include damage or irritation to the lateral femoral cutaneous nerve resulting in meralgia paraesthetica. These cases should be considered for surgical intervention as a neurological deficit could occur. Additionally, fragment displacement of >3cm should also undergo surgical intervention. Time course of healing is quicker in the surgical group, with return to sport after 3 months vs 6 months in the conservative group. Ultimate outcomes appear to be the same regardless of intervation type.

References : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4071503/

Uploaded : 1 August 2019