Orthopedic Research Online Journal

Avulsion Fracture of the Gracilis in an Adolescent Swimmer

  • Open or Close Britnie Jones1 and Dani Moffit2*

    1University of Oregon, USA

    2Program Director – Master of Science in Athletic Training, Idaho State University, USA

    *Corresponding author: Dani Moffit, Associate Professor, Program Director - Master of Science in Athletic Training, Idaho State University, 912 S 8th Ave, Stop 8105, Pocatello, ID 83209-8105, USA, Tel: 2082824441; Fax: 2082824654; Email: moffdani@isu.edu

Submission: January 19, 2018; Published: February 08, 2018

DOI: 10.31031/OPROJ.2018.02.000526

ISSN: 2576-8875
Volume2 Issue1


Objective: To describe evaluation and treatment for an avulsion fracture in a sport where this injury is rare.

Background: Adolescents present with the highest number of avulsion fractures due to late ossification between the apophysis and body of the bone causing a weakness in the transfer of force between muscle and bone. This injury is highest in soccer players and gymnasts, specifically at the ischial tuberosity, anterior inferior iliac spine, and anterior superior iliac spine. Gracilis avulsion fractures are rare in swimmers when compared to other sports.

Differential Diagnosis: Groin strain, sports hernia, osteitis pubis.

Treatment: After diagnosis was confirmed through diagnostic ultrasound, a 16-week protocol was followed, similar to one used for hernia repairs, for rehabilitation purposes.

Uniqueness: The original mechanism of injury was caused by internal hip rotation on a planted pivot foot, uncommon for groin strains. The most common mechanism of injury for the secondary avulsion injury is eccentric overload, however this was not the case for this swimmer. The gracilis avulsion occurred while non-weight bearing in a pool. His body weight, being affected by buoyancy, should have reduced the amount of tension on the muscles by approximately 50 percent. Therefore, his concentric muscle action should not have produced the amount of force necessary to avulse the gracilis.

Conclusion: A paucity of literature indicates gracilis avulsion fractures are rare in swimmers. Both conditions in this athlete reported unique mechanisms of injury for sustaining a groin strain or avulsion. Athletic trainers should be aware of the potential for avulsion fractures regardless of the sport or mechanism of injury reported.

Keywords: Avulsion fracture; Swimming; Gracilis apophysitis; Pubic avulsion

Get access to the full text of this article