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Avulsion fracture: How is it treated?
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/avulsion-fracture/AN00200
- With Mayo Clinic physical medicine and rehabilitation specialist
Edward R. Laskowski, M.D.
read biographyclose windowBiography of
Edward R. Laskowski, M.D.
Edward R. Laskowski, M.D.
Dr. Edward Laskowski is certified by the American Board of Physical Medicine and Rehabilitation, including subspecialty certification in sports medicine, and is a fellow of the American College of Sports Medicine. He is co-director of the Mayo Clinic Sports Medicine Center and a professor at College of Medicine, Mayo Clinic.
He has been on the staff of Mayo Clinic since 1990 and specializes in sports medicine, fitness, strength training and stability training. He works with a multidisciplinary team of physical medicine, rehabilitation and orthopedic specialists, physical therapists, and sports psychologists.
Dr. Laskowski is an elite-level skier and an avid hiker, cyclist and climber. He approaches sports medicine from the perspective of a physician and an athlete.
In 2006, President George W. Bush appointed Dr. Laskowski to the President's Council on Physical Fitness and Sports, and he has received a Distinguished Service Award from the Department of Health and Human Services for his contribution to the Council.
Dr. Laskowski was a member of the medical staff of the Olympic Polyclinic at the 2002 Winter Olympics in Salt Lake City and has provided medical coverage for the Chicago Marathon. He serves as a consulting physician to the National Hockey League Players' Association and is a featured lecturer at the American College of Sports Medicine's Team Physician Course.
Dr. Laskowski, a Cary, Ill., native, has contributed to Mayo Clinic's CD-ROM on sports, health and fitness, a website guide to self-care, and hundreds of Mayo Clinic articles and booklets in print and online. He is a contributing editor to the "Mayo Clinic Fitness for EveryBody" book, and he has presented lectures throughout the world on health, fitness and sports medicine topics. His teaching expertise has been recognized by his election to the Teacher of the Year Hall of Fame at Mayo Clinic.
"There are many myths and misconceptions about exercise and fitness in general, and also many traditions that don't stand up to scientific scrutiny," he says. "My goal is to provide the most up-to-date and accurate information on sports medicine and fitness topics in a way that you can practically incorporate into your life."
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Question
Avulsion fracture: How is it treated?
What is the best way to treat an avulsion fracture in a young athlete?
Answer
from Edward R. Laskowski, M.D.
An avulsion fracture occurs when a tendon or ligament, along with a piece of the bone it's attached to, gets pulled away from the main part of the bone. Avulsion fractures in young athletes often involve tendons that attach the hamstring muscle to one of the pelvic bones, the hip flexor muscles to the pelvis or thighbone, or the inner forearm muscles to the inner side of the elbow.
Conservative treatment — resting and icing the affected area, then doing controlled exercises to stretch the tendon and promote bone healing — is usually all that's needed for an avulsion fracture to heal. If the hip muscles are affected, however, you may need to spend a few weeks on crutches. Complete recovery can take from four to eight weeks.
If the bone fragment and main bone are too far apart to fuse naturally, surgery may be necessary to reunite them — particularly for hamstring avulsion fractures. Surgery also may be necessary later to remove the painful, fibrous tissue (soft tissue union) that sometimes forms around unhealed fractures. In children, avulsion fractures that occur on a growth plate also may require surgery.
The vast majority of avulsion fractures heal very well without surgical intervention, but be sure to talk to your doctor about the best treatment for your specific injury.
- Shah A, et al. Hip, pelvis and thigh. In: DeLee JC, et al. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4160-3143-7..00021-X&isbn=978-1-4160-3143-7&uniqId=257466777-3#4-u1.0-B978-1-4160-3143-7..00021-X. Accessed June 7, 2011.
- Rab GT. Pediatric orthopedic surgery. In: Skinner HB, ed. Current Diagnosis & Treatment in Orthopedics. 4th ed. New York, N.Y.: The McGraw-Hill Companies; 2006. http://www.accessmedicine.com/content.aspx?aID=2316412&searchStr=avulsion+fracture#2316412. Accessed June 7, 2011.
- Laskowski ER (expert opinion). Mayo Clinic, Rochester, Minn. June 14, 2011.
- Ray TR. Youth baseball injuries: Recognition, treatment, and prevention. Current Sports Medicine Reports. 2010;9:294.
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