Endoscopic-assisted percutaneous fixation for displaced anterior inferior iliac spine avulsion fractures: a prospective cohort study
Abstract Introduction Anterior inferior iliac spine (AIIS) avulsion fractures commonly occur in adolescent patients during sports activities. To systematically evaluate fracture severity and guide management, an adaptation of the Hetsroni classification system was used to categorize fractures on the...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2025-03-01
|
| Series: | Journal of Orthopaedics and Traumatology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s10195-025-00831-4 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850251783912292352 |
|---|---|
| author | Andrea Audisio Alessandro Aprato Virginia Reinaudo Giuseppe Sinatra Lorenzo Lucchino Alessandro Massè |
| author_facet | Andrea Audisio Alessandro Aprato Virginia Reinaudo Giuseppe Sinatra Lorenzo Lucchino Alessandro Massè |
| author_sort | Andrea Audisio |
| collection | DOAJ |
| description | Abstract Introduction Anterior inferior iliac spine (AIIS) avulsion fractures commonly occur in adolescent patients during sports activities. To systematically evaluate fracture severity and guide management, an adaptation of the Hetsroni classification system was used to categorize fractures on the basis of their displacement relative to the acetabular rim. Traditional open reduction and internal fixation reported satisfactory consolidation rates but complications such as lateral femoral cutaneous nerve (LFCN) neuropathies, heterotopic ossifications (HO), and subspine impingement. The objectives of this work are to (1) report short- and mid-term radiographic and clinical outcomes and (2) propose an adapted classification system based on the risk of subsequent subspine impingement. Materials and methods A prospective cohort study was conducted on patients with AIIS avulsion fracture with ≥ 1.5 cm displacement who underwent surgery between 2021 and 2024. Patients with follow-up < 6 months, displacement < 1.5 cm, comminuted fractures, or chronic fractures were excluded. Clinical outcomes, including the subspine impingement test, the modified Harris Hip Score (mHHS), and the University of California Los Angeles Score (UCLA), were evaluated at last follow-up. Postoperative complications, such as LFCN neurapraxia, HO (classified by Brooker), and surgical revisions, are reported. Results Eleven male patients with mean age of 14.1 years (range 12.8–15.0 years) were included. Fractures were classified as type I in two patients (18.2%), type II in four patients (36.4%), and type III in five patients (45.4%). The mean surgical duration was 71.4 min (SD 17.1 min), and the average time from injury to surgery was 4.2 days (range 1–11 days). The mean fracture displacement was 18.3 mm (range 15–25 mm). Postoperative scores averaged 89.7 for mHHS (SD 3.1) and 9.7 for UCLA (SD 0.6). Patients were followed for 20.0 months (range 6–47 months, SD 13.3 months). One patient underwent open surgical revision and subsequently experienced temporary LFCN neurapraxia, HO (Brooker 1), and symptoms of subspine impingement. Conclusions Endoscopic-assisted percutaneous fixation is an effective technique for treating displaced AIIS avulsion fractures. Preliminary results suggest that this approach offers noninferior results, satisfactory outcomes, and limited complications. Further studies with long-term follow-up are needed to confirm these findings. |
| format | Article |
| id | doaj-art-f1fdbb424dd24ebca4df9c32f0f8aac0 |
| institution | OA Journals |
| issn | 1590-9999 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Orthopaedics and Traumatology |
| spelling | doaj-art-f1fdbb424dd24ebca4df9c32f0f8aac02025-08-20T01:57:49ZengSpringerOpenJournal of Orthopaedics and Traumatology1590-99992025-03-0126111010.1186/s10195-025-00831-4Endoscopic-assisted percutaneous fixation for displaced anterior inferior iliac spine avulsion fractures: a prospective cohort studyAndrea Audisio0Alessandro Aprato1Virginia Reinaudo2Giuseppe Sinatra3Lorenzo Lucchino4Alessandro Massè5Pediatric Orthopaedics and Traumatology, Regina Margherita Children’s HospitalPediatric Orthopaedics and Traumatology, Regina Margherita Children’s HospitalDepartment of Surgical Sciences, University of TurinDepartment of Surgical Sciences, University of TurinDepartment of Surgical Sciences, University of TurinDepartment of Surgical Sciences, University of TurinAbstract Introduction Anterior inferior iliac spine (AIIS) avulsion fractures commonly occur in adolescent patients during sports activities. To systematically evaluate fracture severity and guide management, an adaptation of the Hetsroni classification system was used to categorize fractures on the basis of their displacement relative to the acetabular rim. Traditional open reduction and internal fixation reported satisfactory consolidation rates but complications such as lateral femoral cutaneous nerve (LFCN) neuropathies, heterotopic ossifications (HO), and subspine impingement. The objectives of this work are to (1) report short- and mid-term radiographic and clinical outcomes and (2) propose an adapted classification system based on the risk of subsequent subspine impingement. Materials and methods A prospective cohort study was conducted on patients with AIIS avulsion fracture with ≥ 1.5 cm displacement who underwent surgery between 2021 and 2024. Patients with follow-up < 6 months, displacement < 1.5 cm, comminuted fractures, or chronic fractures were excluded. Clinical outcomes, including the subspine impingement test, the modified Harris Hip Score (mHHS), and the University of California Los Angeles Score (UCLA), were evaluated at last follow-up. Postoperative complications, such as LFCN neurapraxia, HO (classified by Brooker), and surgical revisions, are reported. Results Eleven male patients with mean age of 14.1 years (range 12.8–15.0 years) were included. Fractures were classified as type I in two patients (18.2%), type II in four patients (36.4%), and type III in five patients (45.4%). The mean surgical duration was 71.4 min (SD 17.1 min), and the average time from injury to surgery was 4.2 days (range 1–11 days). The mean fracture displacement was 18.3 mm (range 15–25 mm). Postoperative scores averaged 89.7 for mHHS (SD 3.1) and 9.7 for UCLA (SD 0.6). Patients were followed for 20.0 months (range 6–47 months, SD 13.3 months). One patient underwent open surgical revision and subsequently experienced temporary LFCN neurapraxia, HO (Brooker 1), and symptoms of subspine impingement. Conclusions Endoscopic-assisted percutaneous fixation is an effective technique for treating displaced AIIS avulsion fractures. Preliminary results suggest that this approach offers noninferior results, satisfactory outcomes, and limited complications. Further studies with long-term follow-up are needed to confirm these findings.https://doi.org/10.1186/s10195-025-00831-4Anterior Inferior Iliac SpineAvulsion FractureEndoscopic-Assisted FixationSubspine ImpingementPediatric Sports InjuriesProspective Cohort Study |
| spellingShingle | Andrea Audisio Alessandro Aprato Virginia Reinaudo Giuseppe Sinatra Lorenzo Lucchino Alessandro Massè Endoscopic-assisted percutaneous fixation for displaced anterior inferior iliac spine avulsion fractures: a prospective cohort study Journal of Orthopaedics and Traumatology Anterior Inferior Iliac Spine Avulsion Fracture Endoscopic-Assisted Fixation Subspine Impingement Pediatric Sports Injuries Prospective Cohort Study |
| title | Endoscopic-assisted percutaneous fixation for displaced anterior inferior iliac spine avulsion fractures: a prospective cohort study |
| title_full | Endoscopic-assisted percutaneous fixation for displaced anterior inferior iliac spine avulsion fractures: a prospective cohort study |
| title_fullStr | Endoscopic-assisted percutaneous fixation for displaced anterior inferior iliac spine avulsion fractures: a prospective cohort study |
| title_full_unstemmed | Endoscopic-assisted percutaneous fixation for displaced anterior inferior iliac spine avulsion fractures: a prospective cohort study |
| title_short | Endoscopic-assisted percutaneous fixation for displaced anterior inferior iliac spine avulsion fractures: a prospective cohort study |
| title_sort | endoscopic assisted percutaneous fixation for displaced anterior inferior iliac spine avulsion fractures a prospective cohort study |
| topic | Anterior Inferior Iliac Spine Avulsion Fracture Endoscopic-Assisted Fixation Subspine Impingement Pediatric Sports Injuries Prospective Cohort Study |
| url | https://doi.org/10.1186/s10195-025-00831-4 |
| work_keys_str_mv | AT andreaaudisio endoscopicassistedpercutaneousfixationfordisplacedanteriorinferioriliacspineavulsionfracturesaprospectivecohortstudy AT alessandroaprato endoscopicassistedpercutaneousfixationfordisplacedanteriorinferioriliacspineavulsionfracturesaprospectivecohortstudy AT virginiareinaudo endoscopicassistedpercutaneousfixationfordisplacedanteriorinferioriliacspineavulsionfracturesaprospectivecohortstudy AT giuseppesinatra endoscopicassistedpercutaneousfixationfordisplacedanteriorinferioriliacspineavulsionfracturesaprospectivecohortstudy AT lorenzolucchino endoscopicassistedpercutaneousfixationfordisplacedanteriorinferioriliacspineavulsionfracturesaprospectivecohortstudy AT alessandromasse endoscopicassistedpercutaneousfixationfordisplacedanteriorinferioriliacspineavulsionfracturesaprospectivecohortstudy |