Pelvic Avulsion Fracture
What is it?
An avulsion fracture occurs when a piece of bone tears away from the site where the muscle attaches to the bone. Muscle attaches to bone by a thick tissue called a tendon. When a muscle contracts quickly or forcefully, it can cause the tendon to pull off a part of the bone.
A pelvic avulsion fracture refers to a broken part of bone that occurs in the pelvis area, which includes the hips, buttocks, and upper thigh area. Several muscles in the pelvis area can cause avulsion fractures and pain at different areas along the pelvis, especially where there are open growth plates in children and teens. Irritation of the growth plate without a piece of broken bone pulled off is known as apophysitis.
Why come to The Children’s Hospital for treatment of this condition?
Children’s has the only sports medicine program in Colorado that is focused solely on caring for young athletes. Our team of sports medicine experts understand the demands that sports programs place on school-aged athletes and the importance of customized, age-appropriate care. Since many young athletes are still growing, they need special kid and teen-specific treatment that takes this into consideration.
Our pediatric specialists are fellowship-trained in sports medicine, giving them the focused expertise that makes The Children's Hospital the best choice for young athletes looking to maximize performance after recovering from a sports injury.
What are the signs and symptoms?
Pelvic avulsion fractures typically cause sudden, severe pain at the site of the bone injury. Other symptoms include swelling, bruising, limited motion, painful motion and limping.
Some common sites of pelvic avulsion fractures include the iliac crest (top of the hip bone), the front of the pelvis and the ischial tuberosity (the buttock area or the “sit bones”). These types of fractures are caused by sudden, forceful contraction of the abdominal muscles, the hip and thigh muscles or the hamstring muscles.
How do you diagnose it?
Your doctor will examine the areas that are painful to the patient. Due to pain or muscle tearing, tests of muscle strength and range of motion may show weakness or inability to move. Your healthcare provider may order an x-ray of the pelvic area to look for a piece of bone that has been pulled off.
How do we treat it?
Pelvic avulsion fractures require a long period of rest and changes in activity in order to heal. Typically, these injuries will get better with 4 to 6 weeks of rest. Your child’s doctor may recommend the use of crutches for some of this time.
When the injury first occurs, you should place ice on the injured area for 20 minutes every 4 to 6 hours for 2 days. Anti-inflammatory medications may be used to treat pain and swelling. Before your child returns to sports, they may need to go to physical therapy to strengthen and stretch the torn muscles. In very rare situations, such as if the torn bone piece is very large or it is torn away from its original location by a large distance, your doctor may recommend surgery.
Your child can return to their normal activities when they have full strength, good range of motion, minimal pain and can perform all the skills required of their sport.
Who gets it, and can it be prevented?
Young athletes, especially adolescents at the age of puberty, may get pelvic avulsion fractures. Pelvic avulsion fractures are frequently seen in sports that require sprinting, rapid changes in movement or jumping, such as track, soccer, tennis and hockey. Athletes who have tight muscles or who fail to properly warm up and stretch prior to exercise are at greater risk for this type of injury.
