Hip Avulsion Fracture

What is a hip avulsion fracture?

A hip avulsion fracture is a specific type of hip injury that occurs when a tendon or ligament pulls off a piece of bone from the hip or pelvis. The piece of bone breaks away from the main attachment site, causing pain and limited range of motion. Avulsion fractures are most commonly seen in the hip, elbow and ankle. Athletes are most likely to suffer an avulsion fracture, especially those participating in sports that require sudden stops, bursts of speed or a forceful contraction of the pelvic muscles like soccer, tennis, hockey, or sprinting. Dr. Benedict Nwachukwu, orthopedic hip specialist serving Manhattan, Brooklyn, New York City, and surrounding New York boroughs is highly trained and experienced at diagnosing and treating hip avulsion fractures.

What are the symptoms of a hip avulsion fracture?

The symptoms of a hip avulsion fracture may vary, depending on how much of the bone was torn away from the original site. Most common symptoms include:

• Sudden popping sound and pain at time of injury
• Swelling and redness in the hip
• Bruising
• Limited range of motion
• Pain when moving the leg forward or backward

What are the types of hip avulsion fractures?

Hip fractures of this type are classified by where they occur:

• Pelvic avulsion fractures
  • Anterior superior iliac: Located at the top of the pelvis, this is the broad, large bone called the ilium.
  • Anterior inferior iliac: Located at the back of the pelvis, on the bony wing of the ilium.
  • Ischial tuberosity: Located at the bottom of the pelvis, this is the V-shaped bone.
  • Proximal femur avulsion fractures: These types of fractures are still considered pelvic avulsion fractures but are rare and occur on the upper end of the femur (thigh bone.)

How are hip avulsion fractures diagnosed?

Dr. Nwachukwu will obtain a thorough patient history, along with how and when the injury occurred. A physical exam, along with an x-ray may be required for Dr. Nwachukwu to see the condition of the hip and pelvis. Other tests to confirm the diagnosis may include CT-Scan and/or an MRI.

Are children and teens more likely to have an avulsion fracture?

Hip avulsion fractures are more commonly seen in children who are still growing. The growth plates in children, where bone growth takes place, is weaker than the surrounding areas of bone. If a tendon or ligament attaches near a growth plate, the likelihood of an avulsion fracture is higher during an injury.

What is the treatment for a hip avulsion fracture?

Non-surgical treatment:

Minor avulsion fractures, where the fragment of bone has not moved far from the attachment site, can be treated non-surgically. Nonoperative treatment may include:

• RICE: Rest, Ice, Compression, Elevation
• Activity modification to rest the injury and limit movement
• Crutches or a walker to keep weight off the injury
• NSAIDS: Non-steroidal anti-inflammatory drugs to be used as prescribed to help with pain and swelling.

Surgical treatment:

Avulsion fractures that are large have pulled off the attachment site and the tendon has retracted far from the bone. In some cases, the avulsion will pull of a small piece of bone with the tendon.

Surgical intervention may involve using screws or suture anchors to re-attach the avulsed tendon or fixate the torn piece of bone back to the attachment site. Dr. Nwachukwu will discuss the best operative treatment for his patients in Manhattan, Brooklyn, New York City and surrounding New York boroughs who require hip avulsion surgery.

For more information on hip avulsion fractures as well as the excellent treatment options available for this and other hip conditions, please contact the office of Benedict Nwachukwu, MD, orthopedic hip specialist serving Manhattan, Brooklyn, New York City and surrounding New York boroughs.