Comparison of non-surgical and surgical treatment using absorbable screws in anterior-superior iliac spine avulsion fractures with over 1.5 cm displacement

Abstract Introduction There is some debate over the best treatment for anterior-superior iliac spine (ASIS) avulsion fractures, although non-surgical treatment can achieve the same results as open surgery. Hypothesis Absorbable screws can be safely used for ASIS avulsion fractures in children and adolescents. Aim of the study Here, we compared patients on whom no surgery was performed with those who underwent open surgery and investigated the feasibility of using absorbable screws as a new fixation material for treating ASIS avulsion fractures in children and adolescents. Patients and methods We retrospectively analyzed the data of 59 patients diagnosed with ASIS avulsion fractures in our hospital between January 2009 and December 2016. Based on the clinical data, these patients were assigned into group A (non-surgical group) and group B (absorbable screws group). After the inclusion and exclusion criteria were applied, patients’ clinical records, including radiographs, were analyzed. All patients were assessed for range of motion (ROM) and by X-ray as they returned to activity. Evaluation of hip function was done by calculating the American Academy of Orthopedic Surgeons (AAOS) lower limb and hip scores. Results According to AAOS scores, there were significant differences between the two groups at the first and third months postoperatively (p = 0.003), but by the sixth and twelfth months, there was no significant difference (p = 0.42). Significant differences were also observed between both groups regarding callus growth on radiographs, time to resume sporting activities, and occurrence of complications such as meralgia paresthetica. All complications resolved by 6 months follow-up. Conclusion Our study agrees with previous reports, absorbable screws can be safely used for ASIS avulsion fractures with greater than 1.5 cm displacement in children and adolescents. In comparison with non-surgical therapy, our results indicate that absorbable screws are associated with shorter recovery time and lesser early complications. Level of evidence IV, retrospective study with control group.