Pelvis sport injuries Flashcards
1
Q
What is this ?
A
Anterior spine iliac spine avulsion
- young athletes
- throught the physis
- mechanism
- indirect trauma
- sudden and forceful contractionof sartorius and TFL
- occurs during hip extension
2
Q
What muscles originate from the anterior superior iliac spine?
A
-
Sartorius
- insertion: superior medial surface of tibial shaft nr tibial tuberosity- joins gracilis and smeitendinosis at pes anserius
- action: flexes and laterally rotates hip, flexes knee
- Innervation: Femoral n L2/3/4
-
Tensor Fasica Lata
- insertion: iliotibial band
- action: helps stabilise and steady hip/knee joints by putting tension on the iliotibial abnd of fascia
- inneravation:super glutean n L4,5,S1
3
Q
What is the tx of Anterior spine iliac spine avulsion?
A
Non operative
- Rest, Protected weight bearing with crutches, early rom with stretching = most cases
Operative
-
ORIF of avulsion fx
- if displacment >3cm
- painful non unions
4
Q
What is this?
A
- Anterior inferior spine iliac spine avulsion
- an apophyseal injury seen in adolscents
- M>F
- occurs often in sports involving kicking
- occurs due to eccentric contracture of the rectus femoris as hip extends and knee is flexed
*
5
Q
Describe the anatomy of rectus femoris?
A
- Origin
- Straight head from Ant inferior iliac spine
- Reflected head from groove above actebulum
- insertion: base of patella to form the more central portion of the quadriceps femoris tendon
- action: extends the knee
- Inervation; muscular branch of femoral n L2-4
- arterial supply: lateral circumflex A
6
Q
What is the tx of Anterior inferior spine iliac spine avulsion
A
Non operative
- Bed rest, ice activity modification
- most cases
- hip flexed for 2 weeks
- position lessn stretch of affected muscle and apophysis
- guarded weight bearing 4 weeks
7
Q
What is osteitis pubis?
A
- Inflammation of the pubic symphysis caused by repetitive trauma ( adduction/abduction)
- common soccer,hockey, football/running
- vague ill defined symptoms
- localsied tenderness over pubic symphysis
- xray- bony erosions, and often diastatis of symphysis, degenerative change within joint
- TX
- nsaids, rest , activity modification
- may take several months to resolve
8
Q
What is meralgia paresthetica?
A
- Compressive neuropathy of lateral femoral cutaneous nerve
- exacerbated by tight belts
- prolonged hip flexion
- non op tx, nsaids
9
Q
What is obturator nerve entrapement?
A
- Compressive neuropathy of obturator n in ptw with well developed hip adductors
- skaters
- -> chronic medial thigh pain
- TX
- non op
10
Q
What ilioinguinal nerve entrapment?
A
- Compression neuropathy caused by hypertrophy abdominal muscels
- pain worsened by hyperextension of hip
Tx
- majority non op
- op in refractory cases
11
Q
What is piriformis syndrome?
A
- A condition characterised by sciatic symptoms leg pain due to extrapelvic scaitic nerve compression at the hip
- sometimes called= deep gluteal syndrome
- ocurs
- anterior to piriformis
- posterior to obturatir internus/gemelli complex
- at level of ischial tuberosity
- anatomy anomalies may contribute to compression
- bipartite pirifromis
- variations in path of sciatic n
- tumours
- aneursym of gluteal artery
- Pain down back of leg
- FAIR test = flexion, adduction, internal rotation= symtpoms
12
Q
What is the tx of piriformis syndrome?
A
Non operative
-
rest, nsaids,muscle relaxants, physio, steriod injection
- furst line of tx
- focus on stretching piriformia muscle, short external rotatios
- corticosteriod injections directed nr piriformis muscle
Operative
- piriformis release and external siatic neurolysis
- in refractory cases