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.     

髂嵴最高点连线与椎节的关系

目的 明确髂嵴最高点连线与椎节的关系。方法 对５００例腰椎Ｘ线平片进行观察,以年龄、性别和症状进行分组分析。结果 并非所有髂嵴最高点连线均通过Ｌ４棘突,年龄和性别对此连线有影响,而腰腿痛对其无明显影响。结论：手术前应确定好手术节段,手术中仅凭左右侧髂嵴最高点连线来确定椎节,并不准确。     

Anterior superior iliac spine distraction for severe and recalcitrant diabetic foot ulcers

PurposeThe study aimed to introduce anterior superior iliac spine distraction to treat severe and recalcitrant diabetic foot ulcers. For comparison, we also included another group of diabetic foot ulcers treated with proximal tibial cortex transverse distraction.MethodsFrom February 1998 to February 2020, 87 patients (87 feet) with severe and recalcitrant diabetic foot ulcers were treated. The mean age of patients at surgery was 64 years (range, 47 to 87 years). The severity of the narrowed artery was assessed using the ankle-brachial index test. For comparison, another group of 91 patients (91 diabetic foot ulcers) treated with proximal tibial cortex transverse distraction was included.ResultsThe mean preoperative ankle-brachial indexes of the two groups were 0.41±0.07 and 0.39±0.05 (OR 0.65 [95% CI -0.77 to 1.58]; P=0.62), respectively. The mean preoperative limb pain was 3.42±2.84 cm and 3.52±3.11 cm (OR 1.54 [95% CI -077 to 1.35]; P=0.083), respectively. At the 2-year follow-up visit, ulcers healed in 72 (83%) and 74 (81%) patients, respectively (P=0.188). The mean postoperative limb pain was 0.52±0.23 cm and 0.49±0.41 cm (OR 2.32 [95% CI -0.27 to 1.66]; P=0.078), respectively. Pin-site infection occurred in 2 patients and 8 patients (P=0.09), respectively. Ulcer recurrence occurred in 13 (15%) patients and 15 (16%) patients (P=0.205), respectively.ConclusionsAnterior superior iliac spine transverse distraction may be an effective alternative treatment for severe and recalcitrant diabetic foot ulcers. It may be associated with fewer distraction-site complications than proximal tibial cortex transverse distraction.Level of evidenceTherapeutic study, Level IIa.     

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.     

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.     

青少年髂前上棘撕脱骨折的诊治探讨

[目的]探讨青少年髂前上棘撕脱骨折的发病原因及诊疗方法。[方法]上海儿童医学中心骨科2001年1月-2006年1月共收治了15例骨盆髂前上棘撕脱骨折病例，男14例，女1例，年龄12—16岁，急性14人，慢性1人；10例发生在短距离赛跑时，2例发生在足球运动时，各有1例发生在排球、篮球和棒球运动时；X线片和CT检查可以明确诊断并根据撕脱骨片的大小及移位的方向及距离，分别采用切开复位内固定、外展屈髋位石膏固定、卧床休息等不同治疗方法。[结果]14例急性病例，保守及手术治疗效果优良，均达到局部无疼痛，髋关节满幅活动，步态正常，可参加各类体育活动。1例慢性病例为外院保守治疗2个月后转来，局部仍明显疼痛，经本院手术治疗后效果满意。作者认为手术复位内固定者可达到解剖复位，康复时间短，早期活动。[结论]明确髂前上棘撕脱骨折的病因、分类，可以做到正确诊断，合理治疗，早期康复，杜绝各种不良后果。     

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     

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.     

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     

The anatomical variation of the lateral femoral cutaneous nerve in relation to the anterior superior iliac spine and the iliac crest

The location of lateral femoral cutaneous nerve (LFCN) in relation to the anterior superior iliac spine (ASIS) and the iliac crest was investigated in 96 embalmed cadaveric specimens. Fifty-six nerves (58.3%) passed medial to the ASIS. Twenty-two nerves (22.9%) passed at the ASIS. Eighteen nerves (18.8%) passed lateral to the ASIS. The LFCN is usually located at 2.1 ± 0.8 to 3.9 ± 1.0 cm below the crest in the range of 2–5 cm lateral to the ASIS, respectively. When the anterior iliac crest bone graft harvesting is planned, the anatomical variation in this area should be concerned to reduce the risk of LFCN injury.     

旋股外侧血管升支的髂嵴支和髂前下棘支双骨膜瓣转移治疗Perthes病

目的 为儿童股骨头缺血性坏死(Perthes病)提供一种有效且简单易行的显微外科冶疗方法。方法 在32侧下肢标本解剖学研究的基础上，设计旋股外侧血管升支的髂嵴支和髂前下棘支双骨膜瓣转移治疗Perthes病11例。结果 临床治疗11例，术后经过1年～3．5年随访，优良率达82％。结论 该方法能够有效提供股骨头的血供，增加股骨头的成骨能力，是一种治疗Perthes病的有效方法。     

Morbidity associated with anterior iliac crest bone grafting in foot and ankle surgery

BACKGROUND: Substitutes for bone graft have been advocated to avoid the potential morbidity associated with harvest of autogenous iliac crest graft. However, no current commercially available graft equals autogenous bone's osteoinductive and osteoconductive qualities. We reviewed our patients' morbidity after harvest of anterior iliac crest bone grafts for procedures involving the foot and ankle. METHODS: A computerized analysis of patient records was undertaken to identify all patients who had a harvest of unicortical iliac crest bone graft during a 12-year period. Patients were contacted either by telephone or by mailed questionnaire, inquiring about the postoperative morbidity of the procedure. Medical records were reviewed for any related complications. RESULTS: Of the 169 patients identified, 134 could be contacted. Follow-up ranged from 1 to 13 years. Not all patients answered every question. At latest follow up, 120 (90%)-patients reported no pain at the bone graft site. Eleven patients complained of persistent residual numbness lateral to the harvest site on the pelvis. Of these 120 patients, 32 (27%) reported that pain at the graft site was greater than the pain at the operative site during the initial postoperative period. No patients had extra hospital days as a result of the bone graft harvest. No deep infections occurred, although 12 (6.7%) of 180 patients had a postoperative hematoma or seroma. Overall, 116 (90%) of 129 patients were satisfied or very satisfied with their bone graft harvest. CONCLUSIONS: Harvesting of autogenous iliac crest bone graft provides the optimal bone graft material, yields minimal morbidity, and is an acceptable choice in supplementing surgical procedures on the foot and ankle.     

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。     

Avulsion fracture of the anterior superior iliac spine: misdiagnosis of a bone tumour

Avulsion fractures of the anterior superior iliac spine are rare. This injury is usually seen in adolescents, as an avulsion fracture of the apophyses, a result of sudden vigorous contraction or repetitive contraction of the sartorius and tensor fasciae latae muscles. Treatment for this injury is usually conservative; however, surgical management has been reported in those with significant displacement. We present a 14 year old male patient who was referred to our unit for biopsy of a possible pathological fracture of his right ilium. The authors feel it is essential to understand the importance of ruling out a bone tumour, if the possibility has been raised, before managing a suspected fracture. If there is any doubt, the case should be referred to an appropriate sarcoma unit for review prior to any intervention.     

Avulsion-fracture of the anterior superior iliac spine with meralgia paresthetica: a case report

We present a rare case of avulsion-fracture of the anterior superior iliac spine with meralgia paresthetica in a 16-year-old male basketball player. He had sensory disturbance affecting his left lateral thigh 10 days after the injury. Tinel's sign was elicited on percussing the avulsed bony fragment of the anterior superior iliac spine. He underwent open reduction and internal fixation. The lateral femoral cutaneous nerve was noted to be entrapped by one third of the avulsed bony fragment. That fragment was removed, and the remaining portion was reduced and fixed with 2 screws. At week 6, the patient had returned to basketball playing without pain. At week 8, sensory distribution in the left lateral thigh had returned to normal.     

Traumatic unilateral avulsion of the anterior superior and inferior iliac spines with anterior dislocation of the hip: a case report

A sixteen-year-old boy involved in a high-speed motor vehicle accident sustained an anterior hip dislocation and avulsion of the anterior ilium extending from the anterior superior iliac spine to the anterior inferior iliac spine. The hip was emergently reduced, and further imaging was obtained to evaluate the bony injury. Computed tomography confirmed the presence of a large displaced bony fragment representing avulsion of the anterior superior and inferior iliac spines and a smaller fragment from the reflected head of the rectus femoris. The patient underwent open reduction and internal fixation of the ilium two days after the initial injury. Postoperatively, he was allowed to bear weight as tolerated with crutches but to avoid active hip flexion. He went on to an uneventful recovery, and at last report (approximately six months after injury), he had returned to full activity. An extensive review of the literature failed to show a similar injury of ipsilateral avulsion of the anterior superior and inferior iliac spines and reflected head of the rectus femoris.     

钢丝张力带治疗髂前上棘撕脱骨折

髂前上棘撕脱骨折是一种少见类型的骨折。 1996年 1月～ 2 0 0 0年 6月 ,我院共收治髂前上棘撕脱骨折 8例 ,均行切开复位钢丝克氏针内固定 ,功能恢复良好 ,效果满意。1　材料与方法1.1　病例资料　本组 8例 ,均为男学生 ,年龄 14～ 17岁。跑步引起 6例 ,跳高引起 2例。临床表现为 :伤后髂前部位疼痛、肿胀 ,部分有青紫和瘀斑 ,膝、髋关节处于被动屈曲位 ,伸直时疼痛加重 ,休息时缓解。X线片表现 :撕脱骨块脱离髂骨 ,向下移位 3～ 5cm。见图 1。1.2　手术方法　硬膜外麻醉下 ,切口以髂前上棘部位为中心 ,暴露后见撕脱骨块被缝匠肌拉向远方 ,…     

可吸收缝线治疗髂前上棘撕脱骨折

1990—2004年,我院采用可吸收缝线经骨折片钻孔缝扎治疗髂前上棘撕脱骨折25例,取得了满意疗效,报道如下。     

双侧髂前上棘骨骺撕脱1例

1病例资料患者,男,14岁。因双髋部疼痛、活动受限5 d入院。主诉5 d前上体育课医结合七年制2000级,四川成都6100752成都中医药大学附属医院骨科,四川成都610072参加50 m短跑,跑至终点时即感双髋部疼痛,行走受限,当时未摔倒。外院就诊行骨盆正位X线片及骨盆CT检查,诊断为双侧髂前上棘骨骺撕脱,未予处理。因双髋疼痛症状未缓解而来我院就诊。查体:双侧髂前上棘处轻度肿胀,明显压痛,触诊时有骨擦感,可扪及裂缝及骨折块;无放射痛,无明显的血管、神经损伤症状,双侧阔筋膜张肌、缝匠肌肌张力降低。仰卧位时双髋关节可屈曲40°,双髋关节其余各方向…