不同年龄段髂前下棘的解剖学特点分析

目的比较18~40，41~60，≥61岁不同年龄段髂前下棘形态学解剖参数变化。 方法选择正常半骨盆资料155例，其中男性115例，年龄（48±15）岁，女性40例，年龄（53±14）岁，均无髋臼撞击综合征，通过软件测量髂前下棘的最大长度、宽度、高度以及表面积和体积。 结果41~60岁及≥61岁年龄段男性髂前下棘的最大宽度[（12.0±1.9）mm；（12.0±1.8）mm]、表面积[（444.11±139.24）mm²；（469.03±132.26）mm²]以及体积[（910.19±452.34）mm³；（989.09±442.99）mm³]显著大于女性[宽度：（9.5±1.1）mm，（9.5±1.6）mm；表面积：（328.96±92.64）mm²，（326.26±118.32）mm²；体积：（577.04±259.51）mm³，（482.47±254.34）mm³，均P<0.05）。≥61岁年龄段中，男性髂前下棘的最大高度大于女性[（6.1±1.4）mm VS（4.6±1.4）mm，P=0.007）。不同年龄段之间（18~40岁，41~60岁，≥61岁），男性和女性的解剖学参数均无统计学意义。在三个年龄段中，最常见的髂前下棘分型均是1型（18~40岁，86.05%；41~60岁，71.23%；≥61岁，79%）。年龄与髂前下棘的长度、宽度、高度、体积和表面积均没有相关性（均P>0.05）。 结论髂前下棘的解剖形态相对稳定，与年龄没有显著相关性，但同年龄组不同性别髂前下棘的体积和表面积会有显著差异。此外低位髂前下棘（2型）并不一定导致髋臼撞击综合征的出现。     

Avulsion fractures of the anterior inferior iliac spine: the case for surgical intervention

Two cases of avulsion fracture of the anterior inferior iliac spine are reported. One was a missed diagnosis that resulted in exostosis formation needing excision. The second case was an adolescent with significant displacement of the fragment and a primary open reduction and internal fixation was done. A high index of suspicion is necessary to diagnose this relatively rare injury and surgery has a role in carefully selected cases.     

Operative treatment of hip impingement caused by hypertrophy of the anterior inferior iliac spine

A 30-year-old man presented with pain and limitation of movement of the right hip. The symptoms had failed to respond to conservative treatment. Radiographs and CT scans revealed evidence of impingement between the femoral head-neck junction and an abnormally large anterior inferior iliac spine. Resection of the hypertrophic anterior inferior iliac spine was performed which produced full painless restoration of function of the hip. Hypertrophy of the anterior inferior iliac spine as a cause of femoro-acetabular impingement has not previously been described.     

自行车把伤致髂前下棘骨折1例

患者,男,40岁。2009年9月9日骑自行车行驶时发生碰撞,被自行车把戳伤左髂部,伤后因剧烈疼痛来院就诊。查体：左腹股沟部肿胀淤血,皮肤青紫,左髋关节活动受限。摄骨盆正位X线片示：左髂前下棘骨折伴分离移位（图1）。于2009年9月11日予切开复位可吸收螺钉内固定治疗。     

Operative treatment of avulsion fractures of the anterior inferior iliac spine: a two-case report

Abstract Avulsion fractures of the anterior inferior iliac spine (AIIS) are rare injuries of the pelvic ring. In two male athletes this injury was missed during initial examination and therefore was not treated optimally. Six months after the initial injury, the patients felt constant pain, and there was a lump in the thigh region; they both also had limited range of hip motion. Therefore, radiography and magnetic resonance imaging of the hip were performed. Avulsion fracture of AIIS was diagnosed and treated surgically with excision of the avulsed fragment. Two years later, both athletes have completely recovered and returned to their usual sporting activities. Isokinetic muscle testing disclosed that the extensor muscles of the operated side of the knee were weaker than those on the uninjured side.     

Anterior inferior iliac spine apophyseal avulsion fracture

A case of anterior inferior iliac spine (AIIS) apophyseal avulsion fracture caused while playing football is reported. A 16-year-old amateur football player felt severe pain in his left groin while kicking the ball during training. There was point tenderness over the anterior inferior iliac spine (AIIS). Avulsion fracture of AIIS was considered clinically. Radiographs confirmed the diagnosis. He was treated with a conservative rehabilitation program. He is still an active football player. Avulsion fractures follow violent or explosive muscular contractions against a fixed resistance, sudden deceleration, or stretching of the involved muscle or as a result of a direct trauma. This injury usually occurs with an extension moment to the hip joint, with the knee flexed, and it is commonly seen in sports that involve kicking. AIIS avulsion fractures should be a diagnostic consideration in patients with pain in the groin who are involved in activities requiring high-level forces of flexion of the hip.     

Fracture of the anterior superior iliac spine following anterior cervical fusion using iliac crest. Case report.

A case is presented in which fracture of the right anterior superior iliac spine occurred 2 weeks after the right iliac crest had been used as the donor site for a two-level anterior disectomy and fusion.     

脊柱前路手术髂前嵴取骨并发症相关分析

目的:探讨脊柱前路手术髂前嵴取骨的并发症发生情况。方法:回顾性分析2001年1月-2005年9月取髂骨行脊柱植骨融合术的154例患者,取骨部位均为髂前嵴,统计供骨区并发症,分析其相关因素。结果:术后随访时间均超过1年。28例(18.2%)患者发生不同程度的并发症,其中14例(9.1%)出现轻度并发症,12例(7.8%)出现中度并发症,2例(1.3%)出现重度并发症。127例(82.5%)患者接受了问卷调查,其中17例(13.4%)患者诉取骨处疼痛,疼痛自我感觉评分为1-6分(平均2分),其中3例(2.4%)患者需服用非甾体类抗炎药以减轻疼痛;7例(5.5%)患者诉取骨处有麻木感;无患者诉取骨处的疼痛及麻木感影响其日常活动;122例(96.1%)患者对供骨区切口外观满意。结论:髂前嵴取骨并发症中供骨区疼痛及麻木发生率较高,尤其是疼痛,应引起足够的重视。     

可吸收螺钉治疗髂前上棘骨折

我科1995年以来采用可吸收螺钉治疗髂前上棘骨折30例,临床上取得满意效果,现报道如下.     

Malunited anterior inferior iliac spine fracture as a cause of hip impingement: A case report and review of literature

Apophyseal injuries of the pelvis have increased recently with increased participation of teenagers in contact sports. Apophyseal fractures of the pelvis should be ruled out from apophysitis, os acetabuli and bony tumors. We report a case of fracture of anterior-inferior iliac spine following indirect injury to the hip in a young football player. The patient failed to get better with nonoperative management and continued to have pain in the left hip and signs and symptoms of impingement. He improved following surgical excision of the heterotopic bone and did not have any evidence of recurrence at 2 years follow up.     

Avulsion fracture of the anterior superior iliac spine in a volleyball player

Avulsion fractures of the apophyses of the pelvis rarely occur in adolescent athletes as a result of sudden and strong contraction of the muscles attached to the growth cartilage. We present a 16-year-old male patient who had an avulsion fracture of the left anterior superior iliac spine while he was playing volleyball. He presented with complaints of pain in the left hip and difficulty in walking. The diagnosis was made by means of pelvis x-rays, computed tomography, and three-phase radionuclide bone imaging. He underwent conservative treatment with a non-steroidal anti-inflammatory drug and bed rest. After two weeks, ambulation with crutches was allowed. At the end of four weeks, he was able to walk without crutches. He returned to his preinjury level of sports activities at the end of six weeks, without any complaint of pain.     

Making a case for anterior inferior iliac spine/subspine hip impingement: three representative case reports and proposed concept

Femoroacetabular impingement is typically described as occurring due to a conflict between the femoral head-neck junction and acetabular rim. A prior case report described an open decompression of the anterior inferior iliac spine (AIIS) due to impingement against the proximal femur. AIIS impingement may be developmental or the result of a prior AIIS avulsion or pelvic osteotomy. We describe 3 representative cases with minimum 1-year follow-up treated with an arthroscopic AIIS decompression.     

Definition of two types of anterior superior iliac spine avulsion fractures

Fractures of the anterior superior iliac spine (ASIS) in adolescents are usually due to avulsion of the sartorius origin from the ASIS; however, the authors here report a second type due to avulsion of the tensor fascia lata origin. Eight patients were identified with ASIS avulsion fractures. Type II sartorius avulsion fracture was due to sprinting in various sports (n = 6). The fragment was smaller and displaced anteriorly. Type II tensor fascia lata avulsion fractures were due to swinging a baseball bat. The two muscular males were both injured during the initial phase of batting. The bony fragment was much larger and displaced laterally as confirmed by three-dimensional computed tomography scans.     

不可吸收缝线治疗髂前上棘撕脱性骨折

正2012年7月~2015年10月,我们采用不可吸收缝线治疗11例髂前上棘撕脱骨折患者,效果满意,报道如下。1材料与方法1.1病例资料本组11例,均为男性,年龄11~16岁。就诊时可见患者轻度屈髋体位,髂前上棘处肿胀、压痛。受伤至手术时间4 h~5 d。1.2治疗方法全身麻醉下手术。患者仰卧,患肢稍屈髋屈膝外旋位。以髂     

Alternative management of iliac vein injury during anterior lumbar spine exposure

Vascular injuries are, unfortunately, common complications during anterior approach to lumbar spine, with venous injuries occurring most frequently. The L4-L5 level of exposure is associated most commonly with venous injuries because it requires significant mobilization of the vascular structures. We present two cases of left common iliac vein tears encountered during redo anterior exposure for spine revision. This was in the setting of an anterior lumbar interbody fusion at the L4-L5 level and for the repeat disc arthroplasty at the L5-S1 level. We describe the endovascular technique used to successfully repair venous tear with the deployment of a covered stent across the injury, preventing the ligation of the left common iliac vein.     

Reduction of donor site morbidity of the iliac crest free flap by preservation of the anterior superior iliac spine

To reduce donor site morbidity in the iliac crest free flap, we suggest leaving the anterior superior iliac spine in situ. The advantages are: less tension on the wound, less pain, faster rehabilitation, preservation of the ability to wear pants without braces, and a better cosmetic result through preservation of contour. Received: 1 December 1999 / Accepted: 1 February 2000     

双侧髂前上棘撕脱骨折1例

患者，男，18岁，学生，以“双侧髂前上棘肿痛1周，加重1d”就诊。1周前患者上体育课跑步后感双髂前上棘处疼痛，当时未予重视，休息后稍缓角，1d前再次参加田径比赛后出现双侧髂前上棘处疼痛加重，拒按，肿胀明显，双正肢伸直时疼痛加剧，行走困难，以肌肉拉伤外搽消肿止痛酊治疗，体息后症状不缓解，遂来我院求治。