{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:10:05Z","timestamp":1756307405022,"version":"3.44.0"},"reference-count":20,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,6]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>We present an unusual ischial fracture unreported in the literature. We discuss the mechanism and describe the appropriate investigations and surgical management of this fracture. A 36-year-old man sustained a direct blow to his right buttock following a fall from a dirt bike. Examination revealed a firm haematoma, with severe pain on any stretch involving the posterior compartment of the thigh. Radiographs revealed a displaced fracture of the ischial body. CT confirmed integrity of the pelvic ring. The patient underwent open reduction and internal fixation with a partially threaded cannulated screw via a \u2018modified longitudinal\u2019 posterior approach to the ischium. The patient was managed partially weight-bearing for 6 weeks; 6-month follow-up confirmed satisfactory clinical and radiographic outcomes. Clinicians should be aware of this novel pelvic fracture and its unusual presentation, currently not included in any pelvic fracture classification system. We report a novel operative technique for appropriate surgical management of such injuries.<\/jats:p>","DOI":"10.1136\/bcr-2020-240874","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T11:07:51Z","timestamp":1614337671000},"page":"e240874","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["The \u2018nightstick\u2019 ischial fracture: a unique oddity of the pelvic injury family"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9555-8212","authenticated-orcid":false,"given":"Matthew John","family":"Gillespie","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma, Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Navnit S","family":"Makaram","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Royal Infirmary of Edinburgh, Edinburgh, UK"},{"name":"University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim O","family":"White","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel G","family":"Molyneux","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"key":"2025082707574503000_14.2.e240874.1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/S0020-1383(96)90106-0","article-title":"Epidemiology of pelvic ring injuries","volume":"27 Suppl 1","author":"G\u00e4nsslen","year":"1996","journal-title":"Injury"},{"key":"2025082707574503000_14.2.e240874.2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181589fa4"},{"key":"2025082707574503000_14.2.e240874.3","first-page":"470-476","article-title":"Apophyseal avulsion fractures of the pelvis. A review","volume":"89","author":"Calderazzi","year":"2018","journal-title":"Acta Biomed"},{"key":"2025082707574503000_14.2.e240874.4","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1055\/a-0757-8494","article-title":"Avulsion Fractures of the Ischial Tuberosity and Resulting Ischiofemoral Impingement - a Case Report with Literature Review","volume":"157","author":"Rutetzki","year":"2019","journal-title":"Z Orthop Unfall"},{"key":"2025082707574503000_14.2.e240874.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-017-1527-z","article-title":"Operative versus conservative treatment of apophyseal avulsion fractures of the pelvis in the adolescents: a systematical review with meta-analysis of clinical outcome and return to sports","volume":"18","author":"Eberbach","year":"2017","journal-title":"BMC Musculoskelet Disord"},{"key":"2025082707574503000_14.2.e240874.6","unstructured":"Committee on Trauma . Advanced trauma life support for doctors. Student course manual. Tenth edit. Chicago IL: American College of Surgeons, 1997: 444p."},{"key":"2025082707574503000_14.2.e240874.7","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1148\/rg.345135113","article-title":"Pelvic ring fractures: what the orthopedic surgeon wants to know","volume":"34","author":"Khurana","year":"2014","journal-title":"Radiographics"},{"key":"2025082707574503000_14.2.e240874.8","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.160.2.3726125"},{"key":"2025082707574503000_14.2.e240874.9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1302\/0301-620X.70B1.3276697","article-title":"Pelvic ring fractures: should they be fixed?","volume":"70","author":"Tile","year":"1988","journal-title":"J Bone Joint Surg Br"},{"key":"2025082707574503000_14.2.e240874.10","doi-asserted-by":"crossref","DOI":"10.1001\/jama.1912.04270100218012","article-title":"Fracture of the tuberosity of the ischium due to muscular action","volume":"LIX","author":"Berry","year":"1912","journal-title":"J Am Med Assoc"},{"key":"2025082707574503000_14.2.e240874.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7457.99"},{"key":"2025082707574503000_14.2.e240874.12","doi-asserted-by":"publisher","DOI":"10.3944\/AOTT.2012.2650"},{"key":"2025082707574503000_14.2.e240874.13","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/JSM.0000000000000088","article-title":"Surgical management of traumatic avulsion of the ischial tuberosity in young athletes","volume":"25","author":"Biedert","year":"2015","journal-title":"Clin J Sport Med"},{"key":"2025082707574503000_14.2.e240874.14","first-page":"122","article-title":"Traumatic avulsion fracture of the ischial tuberosity in an elderly patient","volume":"77","author":"Somville","year":"2011","journal-title":"Acta Orthop Belg"},{"key":"2025082707574503000_14.2.e240874.15","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s00590-017-2074-x","article-title":"Operative treatment of pelvic apophyseal avulsions in adolescent and young adult athletes: a follow-up study","volume":"28","author":"Sinikumpu","year":"2018","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"2025082707574503000_14.2.e240874.16","doi-asserted-by":"crossref","first-page":"143","DOI":"10.2106\/00004623-198769010-00023","article-title":"Sciatica caused by an avulsion fracture of the ischial tuberosity. A case report","volume":"69","author":"Miller","year":"1987","journal-title":"J Bone Joint Surg Am"},{"key":"2025082707574503000_14.2.e240874.17","doi-asserted-by":"crossref","first-page":"641","DOI":"10.2106\/00004623-197254030-00018","article-title":"Functional disability following avulsion fracture of the ischial epiphysis. Report of two cases","volume":"54","author":"Schlonsky","year":"1972","journal-title":"J Bone Joint Surg Am"},{"key":"2025082707574503000_14.2.e240874.18","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.00094"},{"key":"2025082707574503000_14.2.e240874.19","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200605000-00012"},{"key":"2025082707574503000_14.2.e240874.20","unstructured":"White TO , Mackenzie SP , Gray AJ . McRae\u2019s orthopaedic trauma and emergency fracture management, 2016: 635p. https:\/\/www.elsevier.com\/books\/mcraes-orthopaedic-trauma-and-emergency-fracture-management\/white\/978-0-7020-5728-1"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-240874","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:57:54Z","timestamp":1756306674000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-240874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,26]]},"published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1136\/bcr-2020-240874"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-240874","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,2]]}}}