The anterior inferior iliac spine is the bony projection below the ASIS on the anterior iliac surface, serving as the origin of the rectus femoris direct head and the iliofemoral ligament. In adolescent athletes the AIIS is an open apophysis that can avulse from explosive hip flexion during sprinting and kicking.
AIIS avulsion fractures occur in adolescent athletes (ages 12 to 17) during explosive sprinting or kicking as the rectus femoris tears the unfused apophysis from the ilium. Radiograph shows the displaced bony fragment anterior and inferior to its normal position. Most are managed conservatively with restricted hip flexion for 6 weeks; displaced fractures greater than 2 cm may require surgical fixation. Sub-AIIS impingement from an enlarged AIIS causes hip impingement in patients with deep hip flexion activities.
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