Delayed Recovery after Nonoperative Treatment of an Avulsion Fracture of the Ischial Tuberosity in an Adolescent Gymnast with a History of Growth Hormone Deficiency: A Case Report.
Prashant Meshram, Amar S Vadhera, Rahul Sachdev and 1 others
PMID 35949383WHAT IT FOUND
A 15-year-old gymnast with prior growth hormone deficiency took 12 months to return to competition after nonoperative treatment of an ischial tuberosity avulsion fracture, longer than the expected three months.
Key findings
01The adolescent gymnast had a Type 2 ischial tuberosity avulsion fracture and chose nonoperative treatment with rest, ice, and crutches.
02Radiographic healing and pain-free status occurred three months after injury, but return to competition occurred 12 months after injury.
03At three-year follow-up, she continued gymnastics and competition without symptoms related to the fracture.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a single case report, so it cannot show whether growth hormone deficiency caused delayed recovery or whether nonoperative treatment is effective. The patient had several possible contributors to delayed recovery, including prior growth hormone deficiency treatment, delayed menarche, secondary amenorrhea, and bone age younger than chronological age. The report describes clinical milestones and symptom status, but it does not provide a comparison group or objective outcome scores. The authors mention other possible factors, such as generalized return-to-play protocols, poor communication, and psychological factors, so the delayed recovery cannot be attributed to one cause.
Declared interests
The authors declared no conflicts of interest and no source of funding.
The easy way to misread this
Do not conclude that growth hormone deficiency caused the delayed recovery or that nonoperative treatment is inadequate. This is one case report, and the authors list several possible contributors, including delayed bone age and amenorrhea.