Atraumatic Hip And Pelvis Injuries: Location Of Injury And Predisposing Factors

PURPOSE: Pediatric athletes experience a disproportionately high occurrence of atraumatic hip and pelvic injuries, notably avulsion fractures, characterized by bone fragments detaching from tendon or ligament attachment sites. Despite available rehabilitative treatment options, these injuries can result in lasting complications such as chronic pain, functional impairment, growth plate injuries, joint stiffness, and recurrent injuries. This retrospective study investigates hip and pelvic injuries in pediatric athletes and explores potential correlations with predisposing factors. METHODS: This study analyzed medical records from 22 pediatric patients presenting with atraumatic hip and pelvic injuries at a New York-based suburban faculty practice from January-November 2023. Patient demographics, injury types, and relevant medical histories were reviewed. Data analysis focused on identifying location of injury, prior injuries, and significant medical history. RESULTS: The cohort was composed of 22 patients with a mean age of 14, of which 15 (68%) were males. Hip and pelvic injury locations included 6 lesser trochanter (27%), 5 anterior inferior iliac spine (23%), 5 iliac crest (23%), 3 inferior pubic ramus (14%), 1 anterior superior iliac spine (5%), 1 symphysis pubis (5%), and 1 other (5%). CAM deformities were found in 11 patients (50%). Of the 22 patients, 7 (32%) had a history of prior relevant injuries and 1 (5%) exhibited a pre-existing condition contributing to increased vulnerability. CONCLUSIONS: Atraumatic hip and pelvic avulsion injuries among pediatric athletes are common and often overlooked, leading to lasting consequences on mobility and quality of life. The results reflect the nuanced nature of associated factors and highlight both the impact of prior injuries and the influence of pre-existing conditions on the occurrence of such injuries in pediatric athletes. Further analysis on the effect of prior injuries and pre-existing conditions is required to fully understand the etiology of pediatric hip and pelvic avulsion injuries, improve clinical management, and refine preventive strategies.