Fractures of the Apophyses in Adolescent Athletes

Fractures of the apophyses are unusual. The first report we found of a fracture of the ischial tuberosity in the American literature was in 1912 by J.M. Berry,1and the largest reported series was by Martin and Pipkin2who reviewed 20 cases of avulsion of the ischial tuberosity to which they added eight cases of their own. They concluded that avulsion fractures of the ischial apophyses were best treated by open reduction or excision. C. Roger Sullivan3contended that the best treatment for these fractures was bed rest until the pain subsided. Because of the direct disparity of these views, a case study was undertaken to review fractures of the apophyses, the muscle forces causing these avulsions, and the methods of treatment available. Report of Cases Case 1.— This 15-year-old white male fell to the floor while jumping in a volleyball game and felt sudden pain in