Ali Adam M, Lewis Angus, Sarraf Khaled M
Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London, W2 1NY, UK.
J Clin Orthop Trauma. 2020 Feb;11(Suppl 1):S4-S6. doi: 10.1016/j.jcot.2019.07.010. Epub 2019 Jul 19.
Avulsion fractures of the ischial tuberosity usually occur in skeletally immature athletes following eccentric contraction of the hamstrings. When displaced fractures are left untreated, subsequent non-union and proximal hamstring fibrosis may lead to chronic pain and reduced activity. However, the indications for and outcomes of operative fixation when presentation is delayed remain unclear. We report the case of a 14 year old male athlete who presented to our institution 6 weeks after sustaining a displaced ischial tuberosity avulsion fracture. He underwent open reduction and internal fixation using a cannulated screw system via a posterior approach, with excellent results at 18 months follow-up. We report our surgical findings in detail as well as a novel method for post-operatively assessing functional screw head prominence-the seated radiograph.
坐骨结节撕脱骨折通常发生在骨骼未成熟的运动员身上，是由腘绳肌的离心收缩引起的。当移位骨折未得到治疗时，随后的骨不连和腘绳肌近端纤维化可能导致慢性疼痛和活动减少。然而，延迟就诊时手术固定的适应症和结果仍不明确。我们报告了一例14岁男性运动员的病例，他在坐骨结节撕脱骨折移位后6周就诊于我们的机构。他通过后路采用空心螺钉系统进行了切开复位内固定，在18个月的随访中取得了优异的效果。我们详细报告了我们的手术发现以及一种术后评估功能性螺钉头突出的新方法——坐位X线片。
