APOPHYSEAL AVULSION FRACTURES OF ANTERIOR INFERIOR ILIAC SPINE

Abstract

We aim to present diagnostic approach and results from surgical treatment in avulsion fractures of the apophysis of Spina Iliaca Anterior Inferior (SIAI).
 Material and methods. During the period 2011 – 2021, seven(7) children with acute traumatic apophysiolysis of SIAI, were operated on, 61 A1.2 fracture by AO/OTA classification. All of the patients are boys with average age 14,1±1,35 years. In all cases the right SIAI is affected and the mechanism of the injury is sports trauma. The diagnostic methods used by us are complete orthopedic clinical examination, AP radiographs of the pelvis and lateral radiographic projections of the hip joint by modified Dunlap technique and also CT scan with 3D reconstruction of the pelvic bones (3cases). In four (4) cases the apophysiolyses are Salter-Harris type I and in three cases – SH type II. The average size of the avulsed bone fragment is 3cm/1cm measured on CT scan and 29,66±3,14 mm on AP radiographic view. Dislocation of the fractured fragment is greater than 1,5cm. In four children the diagnosis from the outpatient care is neglected or primary wrong. This fact procrastinated the treatment for between 15 and 30 days. In the rest of the cases the treatment is prompt in an urgent matter. For all patients open reduction and internal fixation with screw osteosynthesis is performed by using one (4 cases) or two (2 cases) 3,5mm cannulated titanium screws. Consolidation of the fracture and the functional condition by Lower Extremity Functional Scale (LEFS) have been followed.