Updated: 6/3/2017

Anterior Superior Iliac Spine (ASIS) Avulsion

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https://upload.orthobullets.com/topic/3091/images/ASIS2[1]_moved.jpg
https://upload.orthobullets.com/topic/3091/images/avulsionillustration_moved.jpg
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

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Questions (7)
Evidence (7)
VIDEOS & PODCASTS (3)
CASES (1)
EXPERT COMMENTS (3)
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