Avulsion fracture of the ischial tuberosity in a young sprinter: Functional versus radiological assessment

We report the case of a sixteen-year-old high-performance sprinter with an ischial tuberosity avulsion. In these injuries, most of the published literature recommends surgery when the diastasis exceeds 2 cm. Our patient had a 1.9 cm diastasis and was treated conservatively. Various criteria are used to demonstrate recovery after treatment. However, one of our main recovery criteria is functional assessment by isokinetic dynamometry. Whilst the first test showed significant strength imbalance, following rehabilitation hamstring strength underwent substantial normalization despite the absence of radiological healing. The patient resumed competition successfully less than one year after the injury with performance levels which were almost the same as before the injury. This case suggests that functional recovery of the hamstring may be added to radiological assessment as an important rehabilitation criterion and that hamstring strength should be measured accurately and objectively in a preventive approach.