Avulsion fractures occur when tendons or ligaments are subjected to forces greater than they can withstand at the apophysis or enthesis, regardless of fusion status. The pelvis and hip joint are vulnerable to these injuries due to the diverse muscular structures in these structures, which serve as origins for multiple muscles leading to the lower extremities. Pelvic avulsion fractures commonly affect young athletes, but can also occur in adults. The diagnosis typically involves assessing trauma history, a clinical examination, and radiographic imaging. If the diagnosis is unclear, additional tests such as computed tomography and magnetic resonance imaging may assist in the diagnosis and provide useful information for treatment decisions. While most avulsion fractures respond well to conservative treatment, surgical intervention may be preferred in severe displacements, cases of significant retraction in active athletes, or when a faster recovery is necessary. Chronic or neglected injuries may lead to excessive osseous formation around the pelvis, causing impingement syndromes. Recognizing characteristic radiological findings based on pelvic anatomy helps to make an accurate diagnosis, as chronic injuries can mimic tumors or infectious conditions, necessitating a careful differential diagnosis.
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Avulsion Fracture of the Lesser Trochanter and the Use of Conservative Treatment Dawid Bartosik, Bartlomiej Cwikla, Anna Kowalczyk, Michalina Loson-Kawalec, Anna Palka-Szymaniec, Bartosz Starzynski, Alina Keska, Jakub Szkuta, Klaudia Wojcik Cureus.2026;[Epub] CrossRef
Avulsion fractures occur when tendons or ligaments are subjected to forces greater than they can withstand at the apophysis or enthesis, regardless of the fusion status. Given the diverse muscular structures around the pelvis and hip joint, which serve as origins for multiple muscles leading to the lower extremities, these areas are vulnerable to such injuries. Pelvic avulsion fractures commonly af-fect young athletes, but they can also occur in adults. Diagnosis typically involves assessing the trauma history, clinical examination, and radiographic imaging. In cases of unclear diagnosis, additional tests, such as computed tomography or magnetic resonance imaging, may assist in treatment decisions and diagnosis. Although most avulsion fractures respond well to conservative treatment, surgical interven-tion may be preferred in severe displacements, significant retraction in active athletes, or when a faster recovery is necessary. Chronic or neglected injuries may lead to excessive osseous formation around the pelvis, causing impingement syndromes. Recognizing the characteristic radiological findings based on the pelvic anatomy aids in accurate diagnosis because chronic injuries might mimic tumors or infectious conditions, necessitating a careful differential diagnosis.