Kocis J, Visna P, Veselý R
Urazová nemocnice, Brno.
Acta Chir Orthop Traumatol Cech. 2003;70(5):311-3.
The apophysis of the ischial tuberosity usually becomes united with the hipbone by 25 years of age. The highest incidence of avulsion in this region occurs between 15 and 17 years in young active persons. Apophysitis should be differentiated from apophyseolysis or an avulsion fracture of the ischial tuberosity. Apophysitis may be associated with chronic excessive sports activities in young men and women and is manifested by pain in the region involved. Its presence is confirmed by radiographic findings. The patient with an avulsion fracture of the ischial tuberosity reports an injurious event, usually a sudden movement during sports activities, associated with immediate pain. The diagnosis is again confirmed by radiology. Apophysitis is treated conservatively with no resulting problems. The poor healing of an avulsion fracture may result in chronic complaints, particularly painful sitting. This condition is treated by resection of the fractured apophysis. The authors describe the case of a 28-year-old man who complained of experiencing pain when sitting. At 20 years of age, he suffered an avulsion fracture of the ischial tuberosity that was treated conservatively. He was examined at our department and an unhealed fracture of the ischial tuberosity was diagnosed by radiology and computed tomography. The separated bony fragment was removed and the patient was followed up to 1 year. He remained free from any complaints. An avulsion fracture of the ischial tuberosity is an injury rarely reported in our as well as foreign literature. The available case reports are discussed.
坐骨结节的骨骺通常在25岁时与髋骨融合。该区域撕脱伤的最高发病率出现在15至17岁的活跃年轻人中。骨骺炎应与骨骺溶解或坐骨结节撕脱骨折相鉴别。骨骺炎可能与年轻男女长期过度的体育活动有关,表现为受累区域疼痛。通过影像学检查结果可确诊。坐骨结节撕脱骨折的患者会报告有受伤事件,通常是体育活动中的突然动作,并伴有立即出现的疼痛。诊断同样通过放射学检查来确认。骨骺炎采用保守治疗,不会产生问题。撕脱骨折愈合不良可能导致慢性不适,尤其是坐立时疼痛。这种情况通过切除骨折的骨骺来治疗。作者描述了一名28岁男性的病例,该患者抱怨坐立时疼痛。他在20岁时遭受了坐骨结节撕脱骨折,接受了保守治疗。他在我们科室接受检查,通过放射学和计算机断层扫描诊断为坐骨结节骨折未愈合。分离的骨碎片被移除,对患者进行了长达1年的随访。他没有任何不适。坐骨结节撕脱骨折在我们以及国外文献中都是一种很少报道的损伤。文中讨论了现有的病例报告。