Updated: 10/1/2018

Anterior Inferior Iliac Spine Avulsion (AIIS)

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https://upload.orthobullets.com/topic/3131/images/aiis avulsion.jpg
https://upload.orthobullets.com/topic/3131/images/avulsionillustration.jpg
https://upload.orthobullets.com/topic/3131/images/apaaisavulsion.jpg
 
Introduction
  • An apophyseal avulsion injury seen in adolescent athletes
  • Epidemiology
    • demographics
      • most often in adolescents between the ages 14-17
      • males more often than females
      • occurs most often in sports involving kicking
  • Pathophysiology
    • mechanism
      • typically occurs due to eccentric contraction of the rectus femoris (femoral n.)  
        • as hip extends and knee is flexed
        • causes avulsion of its anatomic origin off the pelvis
Anatomy
  • Anterior inferior iliac spine
    • a bony prominence just above acetabulum 
    • is the origin of the direct head of the rectus femoris (femoral n.) 
       
Presentation
  • History
    • sudden "pop" in pelvis
  • Symptoms
    • pain and weakness
  • Physical exam
    • antalgic gait
    • anterior hip pain and hip flexion weakness
Imaging
  • Radiographs  
    • show avulsion of AIIS   
Treatment
  • Nonoperative
    • bed-rest, ice, activity modification
      • indications
        • almost all treated nonoperatively
      • technique
        • hip flexed for 2 weeks
          • position lessens stretch of affected muscle and apophysis
        • follow with guarded weight bearing for 4 week
Complications
  • Loss of reduction
  • Delayed union
 

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(OBQ12.30) A 14-year-old hurdler has the immediate onset of right hip pain after his trailing limb struck a hurdle and he falls down. Figure A demonstrates a right hip AP and lateral radiograph. The muscle originating at the injured structure is innervated by which of the following nerves? Review Topic | Tested Concept

QID: 4390
FIGURES:
1

Genitofemoral nerve

1%

(52/6250)

2

Femoral nerve

87%

(5458/6250)

3

Pudendal nerve

1%

(43/6250)

4

Obturator nerve

3%

(193/6250)

5

Superior gluteal nerve

8%

(475/6250)

L 2 A

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