Avulsion injuries of the pelvis in adolescents

Avulsion fractures of the apophyses of the pelvis are common in adolescent athletes. They usually occur as a result of trauma or overuse, involving especially the anterior inferior iliac spine, anterior superior iliac spine, anterior third of the iliac crest, tuber ischiadicum, and the symphysis pubis. The majority of these injuries occur during vigorous sports, with a male preponderance. They are often mistaken for muscle or tendon injuries. History, physical examination, and radiologic modalities are often helpful in diagnosis. Treatment may vary depending on the localization of the injury and the extent of fragment dislocation, but mainly remains conservative including bed rest, medications, and rehabilitation. Some patients may require surgical treatment, though.