Avulsion Fracture – Hip Flexor

Adeleke Sikes MC° *

KE ,
Georgia College & State University, Milledgeville GA*
Piedmont Academy, Monticello, GA°
Objective: Treatment: Uniqueness:
• To present the case of a high school track (multi-sport) athlete that Spring 2017 Bilateral • Athlete has had an older ill sibling for years
presented pain at the hip flexor on the ASIS, suffered an avulsion Bridge 3X10 Fire hydrant 2X10 • initial complaint of pain when his brother was hospitalized
Week 1 (R) • documented complaint of pain during football season
fracture at the hip, and is continuing to complain of pain at both the SLR (4-way) 3X10 0# Donkey kick 2X10
right and left hip flexors Day 1 • occurred after the passing of his ill brother
Day 2 Bridge 3X10 Fire hydrant 2X10 • sporadic appearance to rehab during the month of September
Patient Background: SLR (4-way) 3X10 0# Donkey kick 2X10 • role of nutrition
Hip theraband 3X10 (Right) Glute med step down 2X10
• nutritional and hormonal imbalances
Step up (3-way) X20
• 5’11 • intake of calcium and Vitamin D
Week 2 Bridge 3X10 Fire hydrant 2X10
• 129 lbs, • lack of support/attention at home
SLR 4-way 3X12 0# Donkey kick 2X10
• Caucasian
(5 min run) Hip theraband 3X10 (Right) Glute med step down 2X10 • one brother as a collegiate athlete
Day 1 Step up 3-way X30 Clam 3X12 • another brother suffering from an illness
• track relay athlete (multisport: baseball and football)
Theraband walk (4-way) 2X10
• ectomorph body composition Bridge 3X10 Fire hydrant 3X12
Day 2
• Athlete had pain at his hip flexor on ASIS SLR 4-way 3X12 0# Donkey kick 3X12
Hip theraband 3X10 (Right) Glute med step down 2X10
• X-ray showed no avulsion fracture or fracture on pelvis
Step up 3-way X30 Clam 2X10
Conclusions:
• no previous medical history Theraband walk (4-way) 2X10
Wall squat 3X10 Diagnosis
• MOI: non-specific
FALL 2017 Bilateral • broken hip during the 4 x 100 relay race in April 2017
• did not require surgery (common)
Differential Diagnoses: Week 1 Bike – 5 min Clam 2X10
• avulsion fracture of Sartorius
SLR 3X10 Donkey kick 2X10
Bridge 3X10 Fire hydrant 2X10 Outcome
• pelvic fracture Wall squat 3x10 Glute med touch 2X10 • able to run 3 miles within 6-8 weeks post-injury
• ASIS avulsion fracture Lunge 2X10 • athlete RTP within 8 weeks of return to rehab (FNL)
Week 2 Bike – 5 min Donkey kick 2X10 • plans to play baseball in the spring
SLR 3X10 (2 lbs) Fire hydrant 2X10 • track is no longer an option
Bridge 3X10 Glute med touch 2X10
Wall squat 3x10 Lunge 2X10

Week 3 SLR 5X10 Clam 3X10

Bridge 5X10
(left) Hamstring curl 5X10
Quad extension 5X10
Russian twist 3X10
Reverse crunch 3X10
Week 4 Running warm-up
SLR 3X10 (green)
Hamstring curl 3X10 (green)
Quad extension 3X10 (green)
Squat 3X10
Bridge
McKinney B, Nelson C, Carrion W. Apophyseal Avulsion Fractures of the Hip and Admin. Apophyseal Avulsion Fractures.; 2016. Week 5 Bridge 2X10 25#
Pelvis.; 2009. Available at:
Available at: https://musculoskeletalkey.com/wp- SLR 3X10 (green)
https://m4.healio.com/~/media/journals/ortho/2009/01_january/apophyseal- content/uploads/2016/11/A320567_1_En_7_Fig4_
avulsion-fractures-of-the-hip-and-pelvis/mckinney_fig2_225_182_35869.jpg HTML.gif
Leg press (180X10, 140X15, 90X20)
Fire hydrant 3X10
Glute med touch 3X10
Lunge 3X10
Plank with kick 3X10
Clam 2X10
Donkey kick 2X10
Fire hydrant 2X10
Bird dog 2X10
Heel touch 2X10
Walking lunge 2X10
Split squat 2X10
Lateral squat 2X10
Curtsey squat 2X10
Band squat 2X10 DL / 2X10 SL Hoogenboom B, Voight M, Prentice W. Musculoskeletal Interventions: Techniques for Therapeutic Exercise, 3e.;
2007. Available at: http://accessphysiotherapy.mhmedical.com/data/books/960/hoo002_fig_02-07.gif
SL RDL 2X10 25#