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Ischial Tuberosity Avulsion Treatment

written by: weborglodge • edited by: Leigh A. Zaykoski • updated: 3/30/2010

Proper ischial tuberosity avulsion treatment depends upon an accurate diagnosis of the condition. Because of its location, it is often misdiagnosed as a hamstring tear. It is a serious condition, requiring prompt treatment as the often sharp pain can make it difficult to sit or stand.

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    Anatomy of the Pelvis

    The pelvis consists of two hipbones fused together in front at a joint called the pubic symphysis and in the back at the sacrum or base of the spine. The ilium is the anterior part of the pelvic girdle, while the ischium forms the posterior portion.

    Together, these sturdy bones support activities such as sitting and walking and provide support for your lower limbs. The ischium provides attachment points for muscles such as the hamstring muscles. The ischial tuberosity is the hard portion that you can feel on your buttocks. A tuberosity is a protuberance of a bone and can be a site of muscle attachment.

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    What is an Avulsion Fracture?

    An avulsion fracture occurs when trauma causes muscle or ligaments to actually pull away a part of the bone. Adolescents and young adults are the greatest risk because of their stage of physical development.

    Certain portions of a growing individual's skeletal system can be considered points of vulnerability. The so-called growth plates or areas of active growth are an example of one such point. In addition, individuals in this age group are more likely to be engaged in intense physical activity. Athletes engaged in track sports such as sprinting and hurdling are most vulnerable.

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    Diagnosis

    There is no mistaking when you have a fracture of the ischial tuberosity. The pain is intense, sometimes debilitating. The pain radiates out from the buttocks, sometimes into the groin area. Since the sciatic nerve is located near the ischium, there are added risks of damaging this large nerve. Because the pain also involves the hamstring muscles, this condition is sometimes diagnosed as a muscle tear rather than a fracture. Doing so will not address the more complicated treatment needed for a fracture.

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    Ischial Tuberosity Avulsion Treatment

    In order to properly diagnose the fracture, your doctor will take x-rays and perhaps a CT scan to determine the extent of the injury. The location of the pain and an inability to bear weight can be considered diagnostic. If the sciatic nerve is injured or f a large portion of the ischial tuberosity is impacted, your doctor will often suggest surgery as the best course of treatment. Surgery may be required for individuals who do not respond quickly to non-surgical treatment.

    Ischial tuberosity avulsion treatment can be long and tedious especially since pain can occur with mundane activities such as sitting. Your doctor will likely recommend prolonged bed rest to allow the swelling and inflammation time to subside. Non-steroidal anti-inflammatory drugs can provide additional relief.

    Because of the long treatment, physical therapy will follow either surgical or non-surgical treatment to help you begin the process of healing and gaining back your strength.

    For the best possible outcome, ischial tuberosity avulsion treatment must begin with proper identification of the cause of pain. Non-surgical and surgical treatment options both carry risk. Your course of treatment will be determined by the degree of damage and the impact to surrounding tissues.

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    References

    Medic8: Avulsion Fracture of Ischial Tuberosity -- http://www.medic8.com/healthguide/sports-medicine/avulsion-fracture.html

    Sports Medicine Information: Avulsion fracture of ischial tuberosity - Buttock pain -- http://www.nsmi.org.uk/articles/buttock-pain/avulsion-fracture.html