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- Title
Ischiofemoral impingement and hamstring dysfunction as a potential pain generator after ischial tuberosity apophyseal fracture non-union/malunion.
- Authors
Spencer-Gardner, Luke; Bedi, Asheesh; Stuart, Michael; Larson, Christopher; Kelly, Bryan; Krych, Aaron; Stuart, Michael J; Larson, Christopher M; Kelly, Bryan T; Krych, Aaron J
- Abstract
<bold>Purpose: </bold>The purpose of this study was to describe the occurrence of ischiofemoral impingement (IFI) and hamstring dysfunction following malunion or non-union of ischial tuberosity apophyseal avulsion fractures and report the short-term outcomes of surgical treatment with regard to alleviating symptomatic extra-articular impingement.<bold>Methods: </bold>All patients who underwent surgery for recalcitrant hip and buttock pain in the setting of prior ischial tuberosity avulsion fracture at three tertiary-level hip preservation centres were included for this review. A total of ten patients met our inclusion criteria and underwent sciatic neurolysis, resection of the ischial tuberosity fragment and hamstring reattachment. Clinical outcomes scores were collected post-operatively including the Modified Harris Hip Score (mHHS) and the Hip Outcomes Score (HOS).<bold>Results: </bold>Ten patients with a mean age of 18 years (range 14-28) underwent surgery for symptomatic ischiofemoral impingement after ischial tuberosity avulsion fracture. At a mean of 2.2-year follow-up (range 1.7-3.5), the median post-operative mHHS was 89.7 (65.7-96.8) and HOS ADL and Sport subscales were 90 % or greater in all cases. Five patients (50 %) rated their hip as normal, and five patients (50 %) rated their hip as near normal.<bold>Conclusion: </bold>Malunion or non-union following ischial tuberosity apophyseal fracture can lead to IFI and hamstring dysfunction. Clinically, the resultant pain and dysfunction is often chronic, and can be debilitating. In select cases, a reliable surgical technique is presented to improve hamstring function and correct ischiofemoral impingement in this setting with good-to-excellent outcomes in the majority of cases at short-term follow-up.<bold>Level Of Evidence: </bold>IV.
- Subjects
HIP joint abnormalities; HAMSTRING muscle injuries; UNUNITED fractures; AVULSION fractures; HIP surgery; BONE fractures; POSTOPERATIVE pain; SPORTS injuries; TREATMENT effectiveness; RETROSPECTIVE studies; ISCHIUM; FEMORACETABULAR impingement
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2017, Vol 25, Issue 1, p55
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-015-3812-4