Pelvic Avulsion Fractures

What is a pelvic avulsion fracture?

There are several muscles in the thigh that attach to various parts of the pelvis. An avulsion is the tearing away of a body part from its point of attachment. An avulsion fracture occurs when a tendon that attaches a muscle to a bone pulls part of the bone away.

How does it occur?

An avulsion fracture may occur after sudden, forceful contraction of the muscle. It is often seen in athletes with tight muscles. Common sites for avulsion fractures include where the sartorius muscle attaches to the top front of the pelvis; where the rectus femoris muscle attaches to the front of the pelvis; where the hamstring muscle group attaches to the part of the pelvis called the ischial tuberosity (the part of your pelvis that you sit on).

What are the symptoms?

Symptoms include pain, tenderness, and swelling at the attachment site of the muscles.

How is it diagnosed?

Your healthcare provider will review your symptoms and examine the injured area. Since the muscle has been torn away from its attachment site, it is possible that you may not be able to perform a muscle function. Your healthcare provider may order an X-ray that would show a piece of bone pulled away from its muscular attachment site.

How is it treated?

Avulsion fractures require rest. In general, they will heal with 4 to 6 weeks of rest. You may need to use crutches for most of this time. If the bony fragment is large or is severely torn away from its original site, surgery may be required.

• Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth on the area every 3 to 4 hours, for up to 20 minutes at a time.
• Take an anti-inflammatory medicine such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.

How long will the effects last?

Pain from a pelvic avulsion fracture may take 1 to 3 months to go away. Ask your healthcare provider when you will be able to return to your normal activities.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities depends on how soon the injured area recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal is to return to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may safely return to your activities when, starting from the top of the list and progressing to the end, each of the following is true:

• You have full range of motion in the injured leg compared to the uninjured leg.
• You have full strength of the injured leg compared to the uninjured leg.
• You can walk straight ahead without pain or limping.

How can pelvic avulsion fractures be prevented?

Since tight muscles are a common cause of avulsion fractures, be sure to do stretching exercises to prevent these injuries from happening again. Warm up properly and stretch your thigh, hamstring, and groin muscles before your activity.