title: [Apophyseal Avulsions of the Hip Region in Adolescents].
abstract: BACKGROUND
  In daily practice apophyseal avulsions of sportive adolescents are frequently being diagnosed with a time delay and treated heterogeneously.
  
  
  OBJECTIVE
  Using the most actual literature and the own experience the current diagnostic and therapeutic strategies are put into perspective with regards of the needs of the adolescent athlete.
  
  
  METHODS
  The apophyseal lesions of the hip area in adolescence are separated in those at the pelvis and those at the proximal femur. They are reviewed according to its frequency and relevance using the most updated literature. The treatment methods reported focus on the degree of dislocation and level of sports activity.
  
  
  RESULTS
  The most frequent apophyseal avulsion of the pelvis is the avulsion of the tuber ischiadicum, followed by the inferior anterior iliac spine the superior anterior iliac spine and the apophysis of the ilium. The most affected structure at the proximal femur is the lesser trochanter, lesions of the greater trochanter are rare. The cause of injury is a specific acute contracture of the muscle inserting at the affected apophysis during different sporting activities. The treatment of pelvic apophyseal injuries is surgical only in cases with considerable fragment dislocation and in high level athletes. At the femoral side the patients are treated almost always conservatively.
  
  
  CONCLUSIONS
  Despite of modern and efficient osteosynthetic techniques the treatment of avulsion lesions of the hip region is mainly conservative, even in athletes. By applying consequent diagnostic and therapeutic principles the development of pseudarthroses and heteropic ossifications can be minimised.
authors.affiliation: Klinik für Orthopädie, Olgahospital, Klinikum Stuttgart, Kriegsbergstraße 62, 70174, Stuttgart, Deutschland. t.wirth@klinikum-stuttgart.de.
authors.forename: T
authors.initials: T
authors.lastname: Wirth
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D000072700:Conservative Treatment / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005260:Female; D000071562:Fractures, Avulsion / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006620:Hip Fractures / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Femur; Heterotopic ossification; Pelvis; Pseudarthrosis; Sports injuries
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