A NOVEL APPROACH TO TREATMENT FOR CHRONIC AVULSION FRACTURE OF THE ISCHIAL TUBEROSITY IN THREE ADOLESCENT ATHLETES: A CASE SERIES

A NOVEL APPROACH TO TREATMENT FOR CHRONIC AVULSION FRACTURE OF THE ISCHIAL TUBEROSITY IN THREE ADOLESCENT ATHLETES: A CASE SERIES: Go to:
CASE 3
The third patient was a 16‐year‐old female school dance team member who reported onset of symptoms after performing a high kick with the right leg in practice. Initially she thought that she had “pulled her hamstring” but her symptoms continued to worsen with time, therefore she sought an orthopedic consult approximately five weeks post injury. At that time she complained of a sharp pain in her right proximal buttock that became worse with stretching or kicking activities. Past medical history was unremarkable other than a prior T7 compression fracture sustained snowboarding at age 10 that healed uneventfully. Radiographs were taken which revealed asymmetry in the apophyseal origin consistent with an avulsion fracture. (Figure 5a) She was instructed from the orthopedic surgeon to take six weeks off dancing activities then referred to physical therapy. Physical therapy consisted of ten visits over a two month period utilzing instrument assisted soft tissue mobilization, exercise (hamstring stretching, isometrics, concentric and eccentric exercises) and interferential stimulation. She experienced a decrease in her pain but when she attempted to return to sport she still reported pain with running and kicking activities in dance. She then returned to the orthopedic surgeon who obtained follow up radiographs, approximately three months following her initial radiographs. (Figure 4b) There was no appreciable healing demonstrated. An MRI was obtained that showed widening of the apophysis without any significant displacement of her ischial tuberosity.