Introduction ASIS avulsions occur in young athletes through the physis Mechanism result from indirect trauma caused by sudden and forceful contraction of sartorius and tensor fascia lata occurs during hip extension (sprinting or swinging a baseball bat) Anatomy Muscles that originate from ASIS sartorius (femoral n.) tensor fascia lata (superior gluteal n.) Presentation History athlete will often report a pop or snap at the time of injury Symptoms may complain of weakness may be confused or misdiagnosed as an acute muscle strain Physical exam may see weakness to hip flexion and knee extension severe injuries may result in a limp Imaging Radiographs displaced fractures usually can be seen on radiographs may be missed due to location and small size of bony fragment CT or MRI can be obtained to confirm the diagnosis Treatment Nonoperative rest, protected weight bearing with crutches, and early ROM and stretching indications most cases Operative ORIF of avulsion fracture indications fractures with displacement of > 3 cm painful nonunions
QUESTIONS 1 of 7 1 2 3 4 5 6 7 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ12.75) A 15-year-old male has the immediate onset of pain during a 100 meter sprint while coming out of the starting blocks and could not complete the race. A pelvis radiograph is shown in Figure A. What is the most appropriate next step in management? Review Topic QID: 4435 FIGURES: A 1 Skeletal survey, chest CT, and referral to an orthopaedic oncologist for biopsy 1% (80/5506) 2 Open reduction and internal fixation 1% (70/5506) 3 Hip abduction brace immobilization with the hip in 45 degrees of flexion and neutral rotation for 6 weeks 2% (119/5506) 4 Protected weight bearing and activity as tolerated 92% (5077/5506) 5 Immobilize in 120 degrees of knee flexion for 24 hours followed by physical therapy 2% (115/5506) ML 1 Select Answer to see Preferred Response PREFERRED RESPONSE 4 Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ12.61) A 12-year-old male has immediate pain and echhymosis over his right groin after injuring himself during a hockey game. His radiograph is shown in figure A. Which of the following statements is true regarding the insertion of his injured muscle? Review Topic QID: 4421 FIGURES: A 1 Inserts on fibular head 2% (87/4754) 2 Insertion on femur is anterior and distal to lateral collateral ligament of knee 7% (328/4754) 3 Can be source of pes anserinus bursitis 65% (3079/4754) 4 Tendon is a harvest option for autograft ACL reconstruction 10% (463/4754) 5 Extends the hip and flexes the knee 16% (779/4754) ML 4 Select Answer to see Preferred Response PREFERRED RESPONSE 3 (SBQ07SM.42) A 14-year-old male sprinter felt a pop and began to experience immediate left hip pain while participating in the 400-meter dash. Upon evaluation, he has difficulty bearing weight due to left hip pain and has tenderness to palpation superior to his left hip joint. Imaging of the pelvis is included in Figure A. Treatment should should include: Review Topic QID: 1427 FIGURES: A 1 Fixation of the femoral neck stress fracture 0% (7/3008) 2 Recession of the iliopsoas to releive internal snapping hip syndrome 0% (7/3008) 3 Fixation of the sartorius origin 6% (175/3008) 4 Fixation of the direct of head of rectus femoris origin 3% (105/3008) 5 Progressive weightbearing with return to activities when pain free motion achieved 90% (2705/3008) ML 1 Select Answer to see Preferred Response PREFERRED RESPONSE 5 (OBQ06.38) An avulsion fracture of the anterior superior iliac spine (ASIS) in a adolescent athlete often occurs from forceful eccentric contraction of which of the following muscles? Review Topic QID: 149 1 External oblique 1% (9/869) 2 Rectus femoris 12% (105/869) 3 Iliopsoas 3% (25/869) 4 Sartorius 84% (728/869) 5 Gluteus medius 0% (1/869) ML 2 Select Answer to see Preferred Response PREFERRED RESPONSE 4
Case Presentations and Panel Discussion with Q&A SESSION V: HIP & FINGER TIP - Moderator T. Sean Lynch, MD (BSM 2018, #43) Knee & Sports - Anterior Superior Iliac Spine (ASIS) Avulsion - All 2:30 pm - Case Presentations and Panel Discussion with Q&ASESSION V: HIP & FINGE... 12/21/2018 54 views Baseball Hip Conditions Update - T. Sean Lynch, MD (BSM 2018, #40) Knee & Sports - Anterior Superior Iliac Spine (ASIS) Avulsion - All 1:45 pm - T. Sean Lynch, MDBaseball Hip Conditions UpdateSESSION V: HIP & FINGER... 12/21/2018 64 views
ASIS avulsion fracture (C1705) Knee & Sports - Anterior Superior Iliac Spine (ASIS) Avulsion HPI - 16 y/o male playing competitive baseball. While up at bat, he completes an aggressive swing and feels a pop above his right hip. He is unable to weight bear on the right leg due to pain. What initial treatment option would you recommend? 11/27/2013 450 7 20