WOFAPS 2025 8th World Congress of Pediatric Surgery

Yangyang Yao, Tianyou Li, Mingang Zhang, Xiaoqing Wang, Lichao Zhu

Shandong Provincial Hospital, Jinan, Shandong, China

Objective: Avulsion fracture of the ischial tuberosity (AFIT) is a rare sports-related injury in adolescents, typically caused by forceful contraction of the hamstring, adductor, and external rotator muscles. This study aims to evaluate short-term outcomes of surgical management for AFIT to provide detailed clinical references.

Methods: We retrospectively analyzed clinical data from 5 AFIT patients undergoing surgical treatment. All received open reduction and internal fixation with cannulated screws. Postoperative follow-ups were conducted to evaluate recovery, with detailed documentation of age, gender, injury-to-surgery interval, fracture displacement , preoperative/postoperative pain levels, functional recovery and complications.

Results: The cohort comprised 4 males and 1 female (mean age 14±0.89 years). Mean follow-up was 5.6±3.61 months. Three patients with >20mm displacement underwent surgery within 5 days. One patient with <10mm displacement received surgery after failed 1-month conservative treatment. Another with 15-20mm displacement underwent surgery due to persistent pain after 1-year conservative management. All patients reported significant pain reduction postoperatively. Partial weight-bearing with crutches was encouraged one weeks post-surgery, and independent walking was achieved by two months. By three months, all patients resumed daily activities without functional limitations.No complications (sciatic nerve injury, infection, or hardware failure) were observed. Imaging confirmed proper fracture healing and implant positioning, with satisfactory patient-reported outcomes.

Conclusion:Current treatment consensus suggests conservative management for displacements <15mm and surgical intervention for >20mm, with 15-20mm cases may require individualized decisions based on activity demands. In this study, all five surgically treated patients demonstrated favorable short-term outcomes, including pain relief and early functional recovery. In clinical practice, it is essential to enhance awareness of AFIT to prevent missed or misdiagnosis, active early diagnosis and appropriate treatment, minimize complications as much as possible, and facilitate early restoration of functional activities.functional activities.