[Ischial tuberosity fractures in children]. / Zlamania guza kulszowego u dzieci.

BACKGROUND: Ischial tuberosity fractures in children are a form of avulsion fractures caused by the strong thigh muscles of the back group (ischiotibial muscles). OBJECTIVE: Presentation of observations covering the diagnostic difficulties, treatment and follow-up of ischial tuberosity fractures in children. MATERIAL AND METHODS: 6 children (one girl and five boys), average age at the time of injury - 13.6 years (12-15.5 years). An analysis of medical and radiological documentation of patients. RESULTS: Two patients with chronic pain were suspected of ischial bone tumor, one was suspected of Perthes disease, and only 3 were sent to the Traumatology Department immediately after the football injury. All patients were treated conservatively. Complete healing of fractures was finally achieved in all patients - (fibrous union in two cases) and finally, after an average period of 9 months, the pain subsided. CONCLUSIONS: There is a discussion in medical literature about the difficulties in the diagnosis of ischial tuberosity fractures, which were primarily unrecognized. Radiological picture of significant bone rebuilding may suggest neoplastic lesions. In the literature dominates the attitude of conservative treatment. Only in cases of large displacement of fracture and chronic ailments caused by pressure on the sciatic nerve, surgery should be considered.

[Iliac spine fractures in children]. / Zlamania kolców biodrowych miednicy u dzieci.

INTRODUCTION: Iliac spine fractures in children are a form of avulsion fractures at mechanically weak spot caused by the presence of the growth plate. OBJECTIVE: Presentation of observations concerning treatment and results of iliac spine fractures in children. MATERIAL AND METHODS: 49 children (1 girl and 48 boys). Age, at the time of injury, average 15.1 years (10.6-18 years). We analyzed medical and radiological documentation of patients. RESULTS: 17 patients sustained anterior superior iliac spine fractures (ASIS), 32 fracture of the inferior iliac spine (AIIS). Most of injuries happened during sport activities--27 patients suffered fracture while playing football. 37 patients asked for medical advice immediately after the injury. Rest of patients, who came late--sustained AIIS fracture. We hospitalized 26 patients (53%), all of them suffered significant pain. The average length of stay in hospital was 8 days. All patients were treated conservatively. All of the fractures healed without complications. DISCUSSION: Larger study than ours group, concerning 84 patients with iliac spine fractures, was presented only by Italian authors who analyzed injures of professional athletes. In literature reviewed conservative treatment strongly predominates. Only a small group of patients were treated surgically (including athletes treated by Croatian surgeons). CONCLUSIONS: The treatment of iliac spines in children should be conservative, consisting of a couple days of bed rest and then for 2-3 weeks walking on crutches with only toe touching until the pain resolves. We recommend return to full activities after 2 months.