Date: Tue, 6 Mar 2001 17:28:37 +0200
Subject: Ischial Tuberosity Fx
From: Dr Savvides
It happened to a fifteen year old boy who was doing the "Long Jump" during his school athletic meeting. The separation as it measures on the CT scan (not shown here) is 1.9 cm.
I would be grateful for your views as regards:
Date: Tue, 06 Mar 2001 15:27:49 -0500
From: Charles Mehlman
This is an impressively displaced ischial avulsion fracture!!! My brief perusal of MEDLINE revealed several reports of "late sciatic nerve complications" following these fractures. There is however, a rather strong precedent for non-operative care.
I would say that if your patient has any signs of nerve irritation at this time - operative treatment could be justified. I would consider an ischial approach similar to what is described for a Triple Innominate Osteotomy (Steel type) and probably "fix the fracture" with strong absorbable suture and make the patient wear at least a one leg spica cast with the hip in full extension.
Charles T Mehlman, DO, MPH
Assistant Professor Pediatric Orthopaedic Surgery
Division of Pediatric Orthopaedic Surgery
Children's Hospital Medical Center Cincinnati
Date: Tue, 6 Mar 2001 15:57:31 -0500
From: bruce meinhard
Most of the literature supports nonoperative treatment. Those who were most dissatisfied were the world class sprinters who responded to operative treatment.The other complication which can occur late besides sciatic nerve problems is that of exuberant bone which interferes with sitting.