REPAIR OF AVULSION FRACTURE OF THE ANTERIOR SUPERIOR ILIAC SPINE BY KNOTLESS SUTURE BRIDGE: SURGICAL TECHNIQUE AND A REVIEW OF 5 CASES


Repair of avulsion fracture of the anterior superior iliac spine by knotless suture bridge: Surgical technique and a review of 5 cases


Tengyun Yang, Yanlin Li, Fuke Wang, Renjie He, Chuan He

Department of Sports Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan province, China, 650032


Background: Avulsion fracture of the anterior superior iliac spine (ASIS) is a rare form of apophyseal avulsion fracture of the pelvis, and there is a lack of evidence-based guidelines for the selection of treatment options. There are various surgical procedures, but there is the risk of secondary removal of internal fixator and growth disturbance caused by epiphyseal fixation.

Methods: We treated 5 patients with avulsion fracture of the anterior superior iliac spine by knotless suture bridge technique who visited our hospital from 2015 to 2020.The surgical treatment results were retrospectively analyzed.

Results: 5 patients with fractures were healed after the surgery, no associated complications, the mean postoperative follow-up was 29.2 months (6-60months), all patients were not reported pain symptoms (visual analogue score of 0), they don’t have the limitation of daily activities, and the hip joint function recovered well, and very pleased with the results (Harris score 100 points) at the final follow-up.

Conclusion: Knotless suture bridge technique is simple and effective in the repair of the avulsion fracture of anterior superior iliac spine. For such patients, this surgical technique can provide stable and reliable fixation, allow early recovery, and provide a feasible scheme for clinical practice.


Keywords: Anterior superior iliac spine; Avulsion fracture; Suture bridge; Surgical technique; Retrospective analysis

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How to cite this article:
Tengyun Yang, Yanlin Li, Fuke Wang, Renjie He, Chuan He. Repair of avulsion fracture of the anterior superior iliac spine by knotless suture bridge: Surgical technique and a review of 5 cases. Internal Journal of Sports Medicine and Rehabilitation, 2021; 4:19. DOI: 10.28933/ijsmr-201-02-2805


References:

1. Cai W, Xie Y, Su Y. Comparison of non-surgical and surgical treatment using absorbable screws in anterior-superior iliac spine avulsion fractures with over 1.5cm displacement. Orthop Traumatol Surg Res. 2020 Nov;106(7):1299-1304.
2. Calderazzi F, Nosenzo A, Galavotti C, Menozzi M, Pogliacomi F, Ceccarelli F. Apophyseal avulsion fractures of the pelvis. A review. Acta Biomed. 2018 Nov 15;89(4):470-476.
3. Eberbach H, Hohloch L, Feucht MJ, Konstantinidis L, Südkamp NP, Zwingmann J. Operative versus conservative treatment of apophyseal avulsion fractures of the pelvis in the adolescents: a systematical review with meta-analysis of clinical outcome and return to sports. BMC Musculoskelet Disord. 2017 Apr 19;18(1):162.
4. Kautzner J, Trc T, Havlas V. Comparison of conservative against surgical treatment of anterior-superior iliac spine avulsion fractures in children and adolescents. Int Orthop. 2014 Jul;38(7):1495-8.
5. Sinikumpu JJ, Hetsroni I, Schilders E, Lempainen L, Serlo W, Orava S. Operative treatment of pelvic apophyseal avulsions in adolescent and young adult athletes: a follow-up study. Eur J Orthop Surg Traumatol. 2018 Apr;28(3):423-429.
6. Bendeddouche I, Jean-Luc BB, Poiraudeau S, Nys A. Anterior superior iliac spine avulsion in a young soccer player. Ann Phys Rehabil Med. 2010 Nov;53(9):584-90.
7. Louaste J, Cherrad T, Rachid K. Arrachements des épines iliaques antéro-supérieures et antéro-inférieures chez l’adolescent sportifs: à propos de deux cas [Tearing of the anterior superior and lower anterior iliac spines in teenage athletes: report of two cases]. Pan Afr Med J. 2015 Dec 11;22:356.
8. Naylor JA, Goffar SL, Chugg J. Avulsion fracture of the anterior superior iliac spine. J Orthop Sports Phys Ther. 2013 Mar;43(3):195.
9. Willinger L, Schanda JE, Lorenz S, Imhoff AB, Buchmann S. Surgical treatment of two adolescent athletes with dislocated avulsion fracture of the anterior superior iliac spine (ASIS). Arch Orthop Trauma Surg. 2017 Feb;137(2):173-177.
10. Heuberer PR, Pauzenberger L, Gruber MS, Kriegleder B, Ostermann RC, Laky B, Anderl W. The knotless cinch-bridge technique for delaminated rotator cuff tears leads to a high healing rate and a more favorable short-term clinical outcome than suture-bridge repair. Knee Surg Sports Traumatol Arthrosc. 2019 Dec;27(12):3920-3928.
11. Anduaga I, Seijas R, Pérez-Bellmunt A, Casasayas O, Alvarez P. Anterior Iliac Spine Avulsion Fracture Treatment Options in Young Athletes. J Invest Surg. 2020 Feb;33(2):159-163.
12. Burns KA, Robbins L, LeMarr AR, Childress AL, Morton DJ, Wilson ML. Rotator Cuff Repair With Knotless Technique Is Quicker and More Cost-Effective Than Knotted Technique. Arthrosc Sports Med Rehabil. 2019 Nov 29;1(2):e123-e130. doi: 10.1016/j.asmr.2019.09.005.
13. Dukan R, Ledinot P, Donadio J, Boyer P. Arthroscopic Rotator Cuff Repair With a Knotless Suture Bridge Technique: Functional and Radiological Outcomes After a Minimum Follow-Up of 5 Years. Arthroscopy. 2019 Jul;35(7):2003-2011.
14. Zwolak P, Meyer P, Molnar L, Kröber M. The functional outcome of arthroscopic rotator cuff repair with double-row knotless vs knot-tying anchors. Arch Orthop Trauma Surg. 2020 Aug 25. doi: 10.1007/s00402-020-03584-3.
15. Cox JT, Shorten PL, Gould GC, Markert RJ, Barnett MD Jr, Laughlin RT. Knotted versus knotless suture bridge repair of the achilles tendon insertion: a biomechanical study. Am J Sports Med. 2014 Nov;42(11):2727-33.
16. Amini MH. Quadriceps Tendon Repair Using Knotless Anchors and Suture Tape. Arthrosc Tech. 2017 Sep 11;6(5):e1541-e1545. doi: 10.1016/j.eats.2017.06.013.
17. Sanderson B, Stumetz K, Jazayeri R. Repair of Proximal Hamstring Tear Utilizing a Suture Bridge Knotless Construct. Case Rep Orthop. 2020 Aug 2;2020:8840418. doi: 10.1155/2020/8840418.