They are most commonly seen affecting the growing apophyses of teenagers and are often missed on initial presentation. It is usually caused by sudden strain or unbalanced contraction on the sartorius or the tensor of the fascia lata. Avulsion fracture of the ASIS represented 1.4% of hip and pelvis injuries. IntroductionĪvulsion fractures of the pelvic apophyses are uncommon, with mean age of 14.4 years, represented by the anterosuperior iliac spine (ASIS) 49%, anteroinferior iliac spine (AIIS) 30%, ischial tuberosity 11%, and the iliac crest. We performed an open reduction and internal fixation with two screws, allowing a return to sport after 3 months and his personal best record in the 100 meters at the 6th postoperative month. X-ray and CT scan confirmed the rare diagnosis of avulsion of the quasitotality of the iliac crest apophysis, corresponding to Salter 2 fracture. Then a total loss of function of the lower limb appears forcing him to stop the run. The traumatism occurred during the period of acceleration phase out of the blocks which corresponds to the maximum traction phase on the tendons. We report a case of 16-year-old male competitive sprinter, who had an avulsion of a part of the iliac crest and the anterior-superior iliac spine during a competition. It usually occurs in teenagers during sport activities, more common in boys. All rights reserved.Avulsion fracture of the iliac crest is an uncommon pathology. Further investigation is warranted to understand the clinical and educational application of these results.Ĭopyright (c) 2010 National University of Health Sciences. Individually, physicians and fellows varied in accuracy and inter-/intraexaminer reliability. Following training of fellows, accuracy increased from both sides of the model (right: kappa = 0.59, left: kappa = 0.53).Ī novel pelvic model was developed to allow assessment of accuracy and reliability of ASIS asymmetry assessment.
Physicians and fellows before training were more accurate from the right side of the model (kappa = 0.56 and kappa = 0.52, respectively). Following training of fellows, interexaminer reliability remained highest from the right side of the model (right: kappa = 0.48, left: kappa = 0.36), whereas intraexaminer reliability was higher from the left side (right: kappa = 0.53, left: kappa = 0.59). Fellows were trained for a week and retested.Īverage interexaminer reliability was greatest from the left side of the model for physicians and from the right side for fellows (physicians: kappa = 0.46, fellows: kappa = 0.37), whereas intraexaminer reliability was greatest from the right in both groups (physicians: kappa = 0.49, fellows: kappa = 0.52). Assessment from the right and left sides of the model occurred on 2 separate days. The purpose of this study was to develop a novel pelvic model and determine the accuracy and the inter- and intraexaminer reliability of anterior superior iliac spine (ASIS) positional asymmetry assessment from both sides of the model by osteopathic predoctoral fellows and osteopathic physicians and to evaluate the effect of training.įive osteopathic predoctoral fellows and 5 osteopathic physicians assessed 13 settings of varied ASIS asymmetry of a novel pelvic model for superior/inferior positional asymmetry from both sides of the model in a random order.
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