Working Diagnosis:
Avulsion fracture of the left anterior-superior iliac spine - sartorius muscle origin avulsion.
Treatment:
Non-weight bearing for 4-6 weeks.
Week 1 - utilized non-steroidal anti-inflammatory medications for pain control, intermittent ice and rest.
Week 2 - partial weight bearing, utilizing heat as needed.
Week 3 - added dynamic flexibility exercises and range of motion exercises.
Week 4 - full weight bearing and started sports specific exercises with dynamic strengthening
Week 6 - full clearance for return to sports.
Outcome:
Patient is participating in all sports. Pain is resolved. Full range of motion of the left hip has been restored.
Editor's Comments:
This is a classic presentation for pelvic avulsion fracture. A "pop" with sudden onset of pain in an athlete with open pelvic growth plates warrants further investigation with pelvic x-ray. The pelvic growth plates are among the last to close and can remain open until age 18-21.
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