Diagnosis and treatment of apophyseal injuries of the pelvis in adolescents.

An avulsion fracture occurs when the growth plate of an apophysis is injured due to a sudden and forceful contraction of the attaching musculotendinous unit. Usually it is adolescents who sustain these injuries, and a significant male preponderance has been found. Even though apophyseal fractures have been described in a variety of locations, the apophyses of the pelvis and hip are more prone to these injuries. Due to their rarity, avulsion fractures of the pelvis are often misdiagnosed. Additionally, patients can present late, and other pathologies are suspected initially. In most acute cases conservative treatment is successful. However, some cases require operative intervention. To plan an optimal treatment regimen, it is important to be familiar with the typical pathomechanism, the typical clinical findings, and the most commonly applied imaging modalities of these injures. The present review analyzes the currently available literature on the most frequently encountered apophyseal injuries of the pelvis in adolescent patients. Some case examples are also presented. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.