Avulsion Fracture of the Ischial Tuberosity of the Pelvis

What is Avulsion Fracture of the Ischial Tuberosity of the Pelvis

Avulsion fracture of the ischial tuberosity of the pelvis is an injury to the bony part of the pelvis where the muscles in the back of the thigh (hamstring muscles) attach to tendons.

These muscles are important in straightening the hip and bending the knee. An avulsion fracture of the ischial tuberosity of the pelvis commonly occurs at a growth plate on the back of the pelvis before the growth plate has closed (fused).

What are the causes?

This injury happens when a tendon pulls off a piece of bone during a powerful contraction of a hamstring muscle. It often happens during activities that involve quick starts, running, jumping, and changing position quickly.

What increases the risk?

This injury is more likely to occur in:

  • People who are younger than 25 years old.
  • People who play sports that involve running, jumping, kicking or quick starts, such as basketball, soccer, gymnastics and track and field.
  • People who have poor strength and flexibility.
  • People who do not warm up properly before practice or play.
  • People who have had a previous injury to the hip, thigh, or pelvis.
  • People who are overweight.

What are the signs or symptoms?

Symptoms of this injury include:

  • Tenderness over the area of injury in the buttocks.
  • Mild swelling, warmth, or redness over the injury.
  • Weakness with activity, especially when extending the hip or bending the knee.
  • Pain with standing or walking.
  • Pain with stretching the hamstring muscle on the injured side.
  • A popping sound that happens at the time of injury.
  • Bruising on the back of the thigh within 1–2 days of the injury.

How is this diagnosed?

This injury is usually diagnosed with a physical exam and X-rays.

How is this treated?

This injury may be treated by:

  • Resting the injured area in a position that decreases the stretch on the involved tendons.
  • Walking with crutches.
  • Taking medicines for pain.
  • Working with a physical therapist to regain strength and motion in the injured area.
  • Surgery. This may be needed in severe cases in which the bone does not heal on its own.

Follow these instructions at home:

Managing pain, stiffness, and swelling

  • If directed, apply ice to the injured area:
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times per day.


  • Do notdrive or operate heavy machinery while taking prescription pain medicine.


  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Perform exercises daily as told by your health care provider or physical therapist.


  • Do notuse the injured limb to support your body weight until your health care provider says that you can. Use crutches as told by your health care provider.

General instructions

  • Do notuse any tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. Tobacco can delay bone healing. If you need help quitting, ask your health care provider.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your symptoms do not improve.
  • You have tingling or numbness in the leg on the side of your injury.

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