The rectus femoris has two proximal origin tendons: the straight (direct) head arising from the anterior inferior iliac spine (AIIS) and the reflected (indirect) head arising from the superior rim of the acetabulum. The direct head is the primary origin and is the more commonly injured in acute avulsion, particularly in adolescents during explosive kicking actions. The direct head tendon is superficial and palpable just below the AIIS.
AIIS avulsion fracture of the direct head rectus femoris origin is the third most common apophyseal avulsion injury (after hamstring and ASIS), occurring in adolescent footballers and sprinters during forceful kicking. Clinical features include acute anterior hip pain with a palpable gap and weakness of hip flexion. Radiograph and CT confirm the avulsion fragment. Conservative management succeeds in most cases; surgical reattachment is considered for large displaced fragments with greater than 2 cm displacement. The reflected head is involved in hip arthroscopy approaches.
Forceful kicking avulses the rectus femoris direct head from the anterior inferior iliac spine in adolescents before apophyseal closure, producing acute anterior hip pain, bruising, and hip flexion weakness; displacement greater than 2 cm on CT is the threshold for surgical reattachment versus conservative management with protected weight-bearing.
This website uses cookies to enhance your experience. Some are essential for site functionality, while others help us analyze and improve your usage experience. Please review your options and make your choice.
If you are under 16 years old, please ensure that you have received consent from your parent or guardian for any non-essential cookies.
Your privacy is important to us. You can adjust your cookie settings at any time. For more information about how we use data, please read our privacy policy. You may change your preferences at any time by clicking on the settings button below.
Note that if you choose to disable some types of cookies, it may impact your experience of the site and the services we are able to offer.
Some required resources have been blocked, which can affect third-party services and may cause the site to not function properly.
This website uses cookies to enhance your browsing experience and ensure the site functions properly. By continuing to use this site, you acknowledge and accept our use of cookies.
