Iliac Crest Avulsion Fracture in a Young Sprinter

Abstract

Avulsion fracture of the iliac crest is an uncommon pathology. It usually occurs in teenagers during sport activities, more common in boys. We report a case of 16-year-old male competitive sprinter, who had an avulsion of a part of the iliac crest and the anterior-superior iliac spine during a competition. The traumatism occurred during the period of acceleration phase out of the blocks which corresponds to the maximum traction phase on the tendons. Then a total loss of function of the lower limb appears forcing him to stop the run. X-ray and CT scan confirmed the rare diagnosis of avulsion of the quasitotality of the iliac crest apophysis, corresponding to Salter 2 fracture. We performed an open reduction and internal fixation with two screws, allowing a return to sport after 3 months and his personal best record in the 100 meters at the 6th postoperative month.

Figure 1

3D CT scan. avulsion of a part of the iliac crest apophysis and the ASIS, downward and more outward.

Figure 2

CT scan. (a) before (left) and after operation (right): reduction and internal fixation with two screws of the avulsion. (b) 3D CT scan. Good position of the fragment with two screws.

Figure 3

Propulsion at the exit of starting block. Hip extension and maximum knee extension, combined with a slight rotation of the trunk, corresponding to a traction on sartorius and fascia lata associated with a traction on abdominal muscle explaining the large lesion.