Absorbable Screws to Treat Anterior-Superior Iliac Spine Avulsion Fractures

The Use of Absorbable Screws to Treat Children and Adolescents With Anterior-Superior Iliac Spine Avulsion Fractures

There is some debate over the best treatment for anterior-superior iliac spine (ASIS) avulsion fractures although conservative treatment can be applied when there are no neurological symptoms. Open reduction and internal fixation can be performed for dislocations exceeding 1.5 cm, or in patients requiring a short period of convalescence, although a second operation is subsequently required to extract osteosynthetic material. In this paper, we introduce the use of absorbable screws as a new fixation material for the second round of surgery.

Study Overview

• Status: Completed
• Conditions: Fractures, Bone; Pediatrics
• Intervention / Treatment: Procedure: open reduction and internal fixation with fixation by absorbable screws

Detailed Description

To investigate the feasibility of absorbable screws as a new fixation material for the treatment of ASIS avulsion fractures in children and adolescents.The investigator plan to retrospectively analyzed 59 patients diagnosed with ASIS avulsion fractures in our hospital between Jan 2009 and Dec 2016. These patients were divided into two groups: group A (conservative group) and group B (absorbable screws). Group A received conservative therapy involving bed rest with the affected lower extremity positioned with the hip and knee in flexion to ensure minimal tension of the muscles attached to the ASIS avulsion fracture. Group B received open reduction and internal fixation with fixation by absorbable screws. Six weeks and three months after treatment, all patients were assessed for range of motion (ROM) and by X-ray as they returned to activity. One week after treatment, the American Academy of Orthopaedic Surgeons (AAOS) lower limb and hip score was used to evaluate hip function; the same scores were also determined during follow-up at 1, 3, 6 and 12 months postoperatively.

• Study Type: Observational
• Enrollment (Actual): 59

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 8 years to 18 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

This study was a retrospective review of one center's experience of treating avulsion fractures of the ASIS in children and adolescents. All patients were evaluated and treated in the same hospital.

Description

Inclusion Criteria:

• avulsion fracture of the ASIS
• new fractures

Exclusion Criteria:

• old avulsion fractures
• delayed fractures
• multiple fractures.

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Retrospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
conservative group; received conservative therapy involving bed rest with the affected lower extremity positioned with the hip and knee in flexion to ensure minimal tension of the muscles attached to the ASIS avulsion fracture.
absorbable screws; received open reduction and internal fixation with fixation by absorbable screws.	Procedure: open reduction and internal fixation with fixation by absorbable screws; Group A received conservative therapy involving bed rest with the affected lower extremity positioned with the hip and knee in flexion to ensure minimal tension of the muscles attached to the ASIS avulsion fracture. Group B received open reduction and internal fixation with fixation by absorbable screws.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
American Academy of Othopaedic Surgeons lower limb and hip scores	Stiffness of the Hip 0-5 scores, higher values represent a better outcome	6th month
American Academy of Othopaedic Surgeons lower limb and hip scores	swelling of the Hip 0-5 scores,higher values represent a better or worse outcome	6th month
American Academy of Othopaedic Surgeons lower limb and hip scores	Walking 0-5 scores ,higher values represent a better or worse outcome	6th month
American Academy of Othopaedic Surgeons lower limb and hip scores	Going up and goingdown stairs 0-5 ,higher values represent a better or worse outcome	6th month
American Academy of Othopaedic Surgeons lower limb and hip scores	bed rest 0-5 scores,higher values represent a better or worse outcome	6th month
American Academy of Othopaedic Surgeons lower limb and hip scores	Moving 0-5 scores,higher values represent a better or worse outcome	6th month
American Academy of Othopaedic Surgeons lower limb and hip scores	wear socks wear socks Wearing socks 0-5 scores,higher values represent a better or worse outcome	6th month

Collaborators and Investigators

• Sponsor: Children's Hospital of Chongqing Medical University

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2009
• Primary Completion (Actual): December 31, 2016
• Study Completion (Actual): January 1, 2018

Study Registration Dates

• First Submitted: June 3, 2019
• First Submitted That Met QC Criteria: June 4, 2019
• First Posted (Actual): June 5, 2019

Study Record Updates

• Last Update Posted (Actual): June 6, 2019
• Last Update Submitted That Met QC Criteria: June 4, 2019
• Last Verified: June 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Fractures, Bone; Fractures, Avulsion
• Other Study ID Numbers: CHCMU-Yuxisu002

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No