Spina Iliaca Anterior Superior Avulsion Fracture: A Case Report and Review of the Literature

Abstract

Spina iliaca anterior superior (SIAS) avulsion fracture is a type of injury that is rare and possible to be overlooked in emergency services. SIAS is the insertion area of the Tensor fascia lata and Sartorius muscles, which are two of the hip flexor muscles and forceful contractions of these muscles which can be observed while kicking a ball, can lead avulsion fractures of SIAS, especially among adolescents. In our case, a 16-year-old male athlete attended the emergency service with a movement restriction and severe pain causing limping that started as an instant pain in the left hip after kicking the ball during a soccer game. It was misdiagnosed as soft tissue injury and no radiological imaging was performed. After plain radiography of the hip was performed in control appointment, the patient was diagnosed as having SIAS avulsion fracture, and a complete and pain-free range of motion was achieved after a conservative treatment of nonsteroid anti-inflammatory drugs, three weeks rest along with cold therapy and walking with crutches without full weight bearing. Even though SIAS fractures are generally treated with conservative methods, they can be misdiagnosed as soft tissue injury in case of poor physical examination and especially displaced fractures may cause clinical problems.