Screw Apophysiodesis for Chronic Ischial Apophysitis Refractory to Apophyseal Drilling in a Teenage Athlete: A Case Report.

CASE: A 17-year-old elite male soccer player, initially treated for chronic ischial apophysitis with transapophyseal drilling 18 months before, presented with persistent apophysitis symptoms and unfused apophysis on imaging. An open screw apophysiodesis was performed. The patient was able to gradually return to play and, within 8 months, was competing symptom-free at a high-level soccer academy. At 1 year postoperatively, the patient was still playing soccer and continued to be asymptomatic. CONCLUSION: In refractory cases not responding to conservative management or transapophyseal drilling, screw apophysiodesis may be used to obtain apophyseal closure with symptom resolution.