East Montgomery Times

Adolescent athletes often face sports-related injuries, with some being particularly rare and difficult to treat. One such injury is the avulsion fracture of the ischial tuberosity (AFIT), which occurs at the hamstring's attachment to the pelvis. This type of fracture is usually caused by high-intensity activities like sprinting and kicking. While non-surgical care can be effective in some cases, others require surgical intervention to restore mobility and prevent complications such as chronic pain and nerve damage.

Researchers and surgeons at Children's Hospital of Philadelphia (CHOP) have conducted a study on AFIT surgical management, focusing on various fixation techniques. The study provides important insights into postoperative outcomes and complications for clinicians dealing with this complex injury.

The research team, led by Dr. Brendan A. Williams along with collaborating surgeons Dr. J. Todd Lawrence, Dr. Lawrence Wells, and Dr. Kathleen J. Maguire, reviewed 16 cases of surgically treated AFIT in adolescents. They compared three fixation techniques: screws, suture anchors, and cortical buttons, evaluating their effectiveness in restoring mobility and returning patients to sports.

Key findings from the study include:

- Most cases involved male athletes (88%), with soccer being the most common sport associated with this injury.

- Cortical buttons emerged as a promising option with no cases of fixation failure or re-fracture.

- Although many patients experienced postoperative complications, most were minor and did not delay recovery.

- All patients successfully returned to sports within six months on average.

The study is one of the first to report outcomes using cortical buttons for AFIT repair. This technique involves anchoring a metallic button on the bone's surface to stabilize the fracture while minimizing disruption to surrounding tissue. "The introduction of cortical buttons in treating ischial tuberosity fractures offers durable and reliable options for treatment of this injury," said Dr. Lawrence.

The findings contribute to the limited but growing body of literature on AFIT management, supporting more informed decision-making and improved patient counseling. "This work enhances our ability to guide families through treatment options," said Dr. Williams.

For more information about this study and other research efforts, visit CHOP’s Orthopedic Center and Sports Medicine and Performance Center.