Pelvis sport injuries Flashcards

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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
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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
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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
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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
    *
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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
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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
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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
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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
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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
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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
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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
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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
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