{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T12:31:07Z","timestamp":1773405067239,"version":"3.50.1"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T00:00:00Z","timestamp":1624492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T00:00:00Z","timestamp":1624492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005713","name":"Technische Universit\u00e4t M\u00fcnchen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005713","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Ischial tuberosity apophyseal fractures are avulsion fractures of the anatomic footprint of the proximal hamstring tendons. Generally, these injuries are rare and frequently occur in skeletally immature, active patients due to incomplete ossification. Depending on the fragment displacement, non-operative or operative treatment approaches are used.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We report a case of a 29-year-old professional volleyball athlete who has suffered from a nonunion avulsion fracture for 14\u2009years. Isolated suture anchor fixation was performed after open excision of a large bony fragment followed by excellent clinical and functional outcome at 1 year postoperatively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In conclusion, avulsion fractures of the ischial tuberosity with large fragments and restrictions to activities of daily living due to pain can, in individualized cases, be treated with an open excision of the fragment followed by repair of the proximal hamstring tendons using suture anchors.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12891-021-04468-2","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T08:03:18Z","timestamp":1624521798000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Delayed proximal hamstring tendon repair after ischial tuberosity apophyseal fracture in a professional volleyball athlete: a case report"],"prefix":"10.1186","volume":"22","author":[{"given":"Patricia M.","family":"Lutz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Kn\u00f6rr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Geyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas B.","family":"Imhoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias J.","family":"Feucht","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"issue":"5","key":"4468_CR1","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1177\/036354658501300510","volume":"13","author":"JN Metzmaker","year":"1985","unstructured":"Metzmaker JN, Pappas AM. Avulsion fractures of the pelvis. Am J Sports Med. 1985;13(5):349\u201358.","journal-title":"Am J Sports Med"},{"issue":"1","key":"4468_CR2","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1186\/s12891-017-1527-z","volume":"18","author":"H Eberbach","year":"2017","unstructured":"Eberbach H, et al. 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. BMC Musculoskelet Disord. 2017;18(1):162.","journal-title":"BMC Musculoskelet Disord"},{"issue":"4","key":"4468_CR3","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1007\/s00167-019-05717-7","volume":"28","author":"M Irger","year":"2020","unstructured":"Irger M, et al. Proximal hamstring tendon avulsion injuries occur predominately in middle-aged patients with distinct gender differences: epidemiologic analysis of 263 surgically treated cases. Knee Surg Sports Traumatol Arthrosc. 2020;28(4):1221\u20139.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"6","key":"4468_CR4","doi-asserted-by":"publisher","first-page":"1813","DOI":"10.1007\/s00167-020-06222-y","volume":"29","author":"HJA Nauta","year":"2020","unstructured":"Nauta HJA, et al. Satisfactory clinical outcome of operative and non-operative treatment of avulsion fracture of the hamstring origin with treatment selection based on extent of displacement: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2020;29(6):1813.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"8","key":"4468_CR5","doi-asserted-by":"publisher","first-page":"e72","DOI":"10.1097\/BPO.0000000000000076","volume":"33","author":"RS Sikka","year":"2013","unstructured":"Sikka RS, Fetzer GB, Fischer DA. Ischial apophyseal avulsions: proximal hamstring repair with bony fragment excision. J Pediatr Orthop. 2013;33(8):e72\u20136.","journal-title":"J Pediatr Orthop"},{"issue":"1","key":"4468_CR6","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s12891-018-2377-z","volume":"20","author":"T Tetsunaga","year":"2019","unstructured":"Tetsunaga T, et al. Avulsion fracture of the ischial tuberosity treated with the suture bridge technique: a case report. BMC Musculoskelet Disord. 2019;20(1):9.","journal-title":"BMC Musculoskelet Disord"},{"issue":"1","key":"4468_CR7","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1007\/s00167-015-3812-4","volume":"25","author":"L Spencer-Gardner","year":"2017","unstructured":"Spencer-Gardner L, et al. Ischiofemoral impingement and hamstring dysfunction as a potential pain generator after ischial tuberosity apophyseal fracture non-union\/malunion. Knee Surg Sports Traumatol Arthrosc. 2017;25(1):55\u201361.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"4468_CR8","doi-asserted-by":"publisher","first-page":"bcr2014205256","DOI":"10.1136\/bcr-2014-205256","volume":"2014","author":"CD Watts","year":"2014","unstructured":"Watts CD, Hartzler RU, Cross WW. Open reduction and percutaneous fixation of a rare hamstring avulsion fracture. BMJ Case Rep. 2014;2014:bcr2014205256.","journal-title":"BMJ Case Rep"},{"issue":"7457","key":"4468_CR9","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1136\/bmj.329.7457.99","volume":"329","author":"S Gidwani","year":"2004","unstructured":"Gidwani S, Jagiello J, Bircher M. Avulsion fracture of the ischial tuberosity in adolescents--an easily missed diagnosis. BMJ. 2004;329(7457):99\u2013100.","journal-title":"BMJ"},{"issue":"Suppl 1","key":"4468_CR10","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1016\/j.jcot.2019.07.010","volume":"11","author":"AM Ali","year":"2020","unstructured":"Ali AM, Lewis A, Sarraf KM. Surgical treatment of an ischial tuberosity avulsion fracture with delayed presentation. J Clin Orthop Trauma. 2020;11(Suppl 1):S4\u20136.","journal-title":"J Clin Orthop Trauma"},{"issue":"20\u201322","key":"4468_CR11","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1080\/09638280701786138","volume":"30","author":"C McGregor","year":"2008","unstructured":"McGregor C, et al. Traumatic and overuse injuries of the ischial origin of the hamstrings. Disabil Rehabil. 2008;30(20\u201322):1597\u2013601.","journal-title":"Disabil Rehabil"},{"issue":"6","key":"4468_CR12","doi-asserted-by":"publisher","first-page":"1936","DOI":"10.1007\/s00167-016-4214-y","volume":"25","author":"WG Blakeney","year":"2017","unstructured":"Blakeney WG, et al. Proximal hamstring tendon avulsion surgery: evaluation of the Perth hamstring assessment tool. Knee Surg Sports Traumatol Arthrosc. 2017;25(6):1936\u201342.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"11","key":"4468_CR13","doi-asserted-by":"publisher","first-page":"2365","DOI":"10.2106\/JBJS.G.00685","volume":"90","author":"DG Wood","year":"2008","unstructured":"Wood DG, et al. Avulsion of the proximal hamstring origin. J Bone Joint Surg Am. 2008;90(11):2365\u201374.","journal-title":"J Bone Joint Surg Am"},{"key":"4468_CR14","doi-asserted-by":"crossref","first-page":"145749692098427","DOI":"10.1177\/1457496920984274","volume":"1","author":"L Lempainen","year":"2021","unstructured":"Lempainen L, et al. Tears of Biceps Femoris, Semimembranosus, And Semitendinosus are Not Equal-A New Individual Muscle-Tendon Concept in Athletes. Scand J Surg. 2021;1:1457496920984274.","journal-title":"Scand J Surg"},{"issue":"4","key":"4468_CR15","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1007\/s00167-019-05748-0","volume":"28","author":"L Willinger","year":"2020","unstructured":"Willinger L, et al. Excellent clinical outcome and low complication rate after proximal hamstring tendon repair at mid-term follow up. Knee Surg Sports Traumatol Arthrosc. 2020;28(4):1230\u20135.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"11","key":"4468_CR16","doi-asserted-by":"publisher","first-page":"2577","DOI":"10.1177\/0363546513499518","volume":"41","author":"HE Skaara","year":"2013","unstructured":"Skaara HE, et al. Self-reported and performance-based functional outcomes after surgical repair of proximal hamstring avulsions. Am J Sports Med. 2013;41(11):2577\u201384.","journal-title":"Am J Sports Med"}],"container-title":["BMC Musculoskeletal Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-021-04468-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12891-021-04468-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-021-04468-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T08:04:38Z","timestamp":1624521878000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/s12891-021-04468-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,24]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["4468"],"URL":"https:\/\/doi.org\/10.1186\/s12891-021-04468-2","relation":{},"ISSN":["1471-2474"],"issn-type":[{"value":"1471-2474","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,24]]},"assertion":[{"value":"26 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 June 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval was not applicable for this case report. All procedures performed were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The subject gave his written informed consent to participate in this investigation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The subject gave his written informed consent for publication of this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that they have no competing interests related to this case report.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"578"}}