Avulsion and Apophysitis

• Avulsion and Apophysitis:

  • Traction injury causing inflammation and stress at the growth areas of bone (apophyses) that have muscles attached to them
  • Often occurs in sporting adolescents
• Avulsion and Apophysitis - Mechanism of injury:

  • Pull of groin muscles
  • Growth spurts
  • Repetitive overuse
  • +/- Avulsion fracture
• Avulsion and Apophysitis - Risk factors:

  • Poor flexibility
  • Repetitive overuse
• Avulsion and Apophysitis - Findings:

  • Pain on palpation of the pubic symphysis
  • X-Ray/MRI needed to confirm presence of an avulsion fracture
• Avulsion and Apophysitis - Management:

  • Reduce load and relative rest
  • Gentle progressive stretching of affected muscle groups to aid in improving flexibility
  • Avulsions can be managed conservatively OR surgically if more than 2.5 cm from normal position