Delayed Recovery after Nonoperative Treatment of an Avulsion Fracture of the Ischial Tuberosity in an Adolescent Gymnast with a History of Growth Hormone Deficiency: A Case Report
# Introduction Avulsion fracture of the ischial tuberosity is uncommon. Patients typically present with symptoms consistent with hamstring strain. The purpose of this case report is to describe an avulsion fracture of the ischial tuberosity and subsequent recovery in an athlete with an endocrine di...
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| Format: | Article |
| Language: | English |
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North American Sports Medicine Institute
2022-08-01
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| Series: | International Journal of Sports Physical Therapy |
| Online Access: | https://doi.org/10.26603/001c.37256 |
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| author | Prashant Meshram Amar S. Vadhera Rahul Sachdev Edward G. McFarland |
| author_facet | Prashant Meshram Amar S. Vadhera Rahul Sachdev Edward G. McFarland |
| author_sort | Prashant Meshram |
| collection | DOAJ |
| description | # Introduction
Avulsion fracture of the ischial tuberosity is uncommon. Patients typically present with symptoms consistent with hamstring strain. The purpose of this case report is to describe an avulsion fracture of the ischial tuberosity and subsequent recovery in an athlete with an endocrine disorder.
# Case Description
A 15-year-old United States of America Gymnastics level 9 gymnast presented with right hamstring pain after regular practice. She had been diagnosed with isolated growth hormone deficiency at age 4 and was treated with growth hormone replacement therapy until age 14. Six months before presentation, she experienced the insidious onset of dull, aching pain in her right hamstring, near the junction of the thigh and buttocks, that was believed to be the result of a chronic hamstring strain. The pain increased gradually over a year and was relieved with rest, massage, and dry needling. Two days before presentation, she felt a "snap" and pain while performing a switch leap during regular practice. She had sharp localized pain in the proximal hamstring with walking and sitting. She was diagnosed with a minimally displaced avulsion fracture of the ischial tuberosity.
# Outcome
With nonoperative treatment, the fracture healed at three months, which is longer than the expected six weeks. Although return to sports is expected three months after this injury, it did not occur until six months in this patient. She was unable to participate in competitive level 9 gymnastics until 12 months after injury.
# Discussion
This case highlights that delayed recovery can occur after avulsion fracture of the ischial tuberosity in adolescent athletes with a history of growth hormone deficiency and treatment using growth hormone.
# Level of Evidence
5 |
| format | Article |
| id | doaj-art-c689a4206cf9487c9f6a49469318825a |
| institution | Kabale University |
| issn | 2159-2896 |
| language | English |
| publishDate | 2022-08-01 |
| publisher | North American Sports Medicine Institute |
| record_format | Article |
| series | International Journal of Sports Physical Therapy |
| spelling | doaj-art-c689a4206cf9487c9f6a49469318825a2025-02-11T20:29:33ZengNorth American Sports Medicine InstituteInternational Journal of Sports Physical Therapy2159-28962022-08-01175Delayed Recovery after Nonoperative Treatment of an Avulsion Fracture of the Ischial Tuberosity in an Adolescent Gymnast with a History of Growth Hormone Deficiency: A Case ReportPrashant MeshramAmar S. VadheraRahul SachdevEdward G. McFarland# Introduction Avulsion fracture of the ischial tuberosity is uncommon. Patients typically present with symptoms consistent with hamstring strain. The purpose of this case report is to describe an avulsion fracture of the ischial tuberosity and subsequent recovery in an athlete with an endocrine disorder. # Case Description A 15-year-old United States of America Gymnastics level 9 gymnast presented with right hamstring pain after regular practice. She had been diagnosed with isolated growth hormone deficiency at age 4 and was treated with growth hormone replacement therapy until age 14. Six months before presentation, she experienced the insidious onset of dull, aching pain in her right hamstring, near the junction of the thigh and buttocks, that was believed to be the result of a chronic hamstring strain. The pain increased gradually over a year and was relieved with rest, massage, and dry needling. Two days before presentation, she felt a "snap" and pain while performing a switch leap during regular practice. She had sharp localized pain in the proximal hamstring with walking and sitting. She was diagnosed with a minimally displaced avulsion fracture of the ischial tuberosity. # Outcome With nonoperative treatment, the fracture healed at three months, which is longer than the expected six weeks. Although return to sports is expected three months after this injury, it did not occur until six months in this patient. She was unable to participate in competitive level 9 gymnastics until 12 months after injury. # Discussion This case highlights that delayed recovery can occur after avulsion fracture of the ischial tuberosity in adolescent athletes with a history of growth hormone deficiency and treatment using growth hormone. # Level of Evidence 5https://doi.org/10.26603/001c.37256 |
| spellingShingle | Prashant Meshram Amar S. Vadhera Rahul Sachdev Edward G. McFarland Delayed Recovery after Nonoperative Treatment of an Avulsion Fracture of the Ischial Tuberosity in an Adolescent Gymnast with a History of Growth Hormone Deficiency: A Case Report International Journal of Sports Physical Therapy |
| title | Delayed Recovery after Nonoperative Treatment of an Avulsion Fracture of the Ischial Tuberosity in an Adolescent Gymnast with a History of Growth Hormone Deficiency: A Case Report |
| title_full | Delayed Recovery after Nonoperative Treatment of an Avulsion Fracture of the Ischial Tuberosity in an Adolescent Gymnast with a History of Growth Hormone Deficiency: A Case Report |
| title_fullStr | Delayed Recovery after Nonoperative Treatment of an Avulsion Fracture of the Ischial Tuberosity in an Adolescent Gymnast with a History of Growth Hormone Deficiency: A Case Report |
| title_full_unstemmed | Delayed Recovery after Nonoperative Treatment of an Avulsion Fracture of the Ischial Tuberosity in an Adolescent Gymnast with a History of Growth Hormone Deficiency: A Case Report |
| title_short | Delayed Recovery after Nonoperative Treatment of an Avulsion Fracture of the Ischial Tuberosity in an Adolescent Gymnast with a History of Growth Hormone Deficiency: A Case Report |
| title_sort | delayed recovery after nonoperative treatment of an avulsion fracture of the ischial tuberosity in an adolescent gymnast with a history of growth hormone deficiency a case report |
| url | https://doi.org/10.26603/001c.37256 |
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