Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA.
J Pediatr Orthop. 2023 Apr 1;43(4):204-210. doi: 10.1097/BPO.0000000000002355. Epub 2023 Jan 23.
Apophyseal avulsion fractures of the pelvis and hip are common injuries in adolescent athletes. However, high volume comparative studies elucidating the spectrum of injuries are largely absent from the literature. The current study provides a comprehensive analysis of demographic, anatomic, pathophysiological, clinical, and athletic-related variables associated with such injuries in an extensive population of affected adolescents.
A retrospective review was performed of records of patients presenting to a single tertiary care pediatric hospital between January 1, 2005, and July 31, 2020, collecting variables including patient sex, age, body mass index, fracture location, injury mechanism, sport at the time of injury, and duration of prodromal symptoms.
Seven hundred nineteen fractures were identified in 709 patients. The average patient age was 14.6, and 78% of the fractures occurred in male patients. The anterior inferior iliac spine (33.4%), anterior superior iliac spine (30.5%), and ischial tuberosity (19.4%) were the most common fracture sites. The most common injury mechanisms were running (27.8%), kicking (26.7%), and falls (8.8%). The most common sports at the time of injury were soccer (38.1%), football (11.2%), and baseball (10.5%). Fracture site was significantly associated with patient sex, age, body mass index, laterality, mechanism, sport, time from injury, and presence of prodromal symptoms. The annual volume of pelvic avulsion fractures treated at the institution increased significantly from n=17 in 2005 to n=75 in 2019.
Adolescent pelvic and hip avulsion fractures occur during a narrow window of age and skeletal maturation and are frequently sustained during sporting activities. Each fracture location is associated with certain demographic, mechanistic, and patient-specific characteristics. The associations between fracture site and patient-specific or injury-specific variables offer insights into the pathophysiology and possible underlying biomechanical risk factors that contribute to these injuries.
This is a level III retrospective study.
骨盆和髋部撕脱性骨折是青少年运动员常见的损伤。然而，在文献中，缺乏大量关于阐明此类损伤谱的高容量比较研究。本研究对大量受影响青少年患者的人口统计学、解剖学、生理学、临床和运动相关变量与此类损伤的关系进行了全面分析。
对 2005 年 1 月 1 日至 2020 年 7 月 31 日期间在一家单一的三级儿科医院就诊的患者记录进行回顾性分析，收集的变量包括患者性别、年龄、体重指数、骨折部位、损伤机制、受伤时的运动项目以及前驱症状持续时间。
在 709 名患者中发现了 719 处骨折。患者的平均年龄为 14.6 岁，78%的骨折发生在男性患者中。前下髂棘（33.4%）、前上髂棘（30.5%）和坐骨结节（19.4%）是最常见的骨折部位。最常见的损伤机制是跑步（27.8%）、踢腿（26.7%）和跌倒（8.8%）。受伤时最常见的运动是足球（38.1%）、橄榄球（11.2%）和棒球（10.5%）。骨折部位与患者性别、年龄、体重指数、侧别、机制、运动项目、受伤至就诊时间以及前驱症状的存在显著相关。该机构治疗的骨盆撕脱性骨折的年数量从 2005 年的 17 例显著增加到 2019 年的 75 例。
青少年骨盆和髋部撕脱性骨折发生在年龄和骨骼成熟的狭窄窗口内，常发生在运动活动期间。每个骨折部位都与某些人口统计学、机械学和患者特异性特征相关。骨折部位与患者特异性或损伤特异性变量之间的关联为这些损伤的发病机制和可能的潜在生物力学危险因素提供了深入了解。
这是一项 III 级回顾性研究。
