Hip and pelvic injuries in the young athlete

Hip and pelvic injuries are relatively rare in the young athlete. Contusions and musculotendinous sprains are the most common injuries about the hip and pelvis. Apophyseal avulsion fractures and stress fractures are the most frequently encountered skeletal injuries. Each of these entities can be successfully treated with guided physical therapy following conservative management with rest, anti-inflammatory medications, and ice massage until the patient is pain free. Epiphyseal, diaphyseal, or pathologic fractures are rare entities that are secondary to violent trauma. These injuries are severe and often require operative intervention. Femoral neck fractures have a high rate of complications from avascular necrosis, nonunion, or malunion. Pelvic fractures have frequent associated genitourinary, abdominal, neurologic, and musculoskeletal injuries. Pathologic fractures are most commonly secondary to benign lesions, such as unicameral bone cysts, and less likely owing to malignancy. Finally, in children with hip pain during athletic activities, even with antecedent trauma, the sports clinician must screen for slipped capital femoral epiphysis, Perthes' disease, congenital subluxation of the hip, toxic synovitis, systemic neoplasia, or infectious process.