Bilateral avulsion fractures of the posterior superior iliac spine in an adult: A case report

Pelvic avulsion fractures are a common consequence of traumatic injuries, yet occurrences at the PSIS (posterior superior iliac spine) site are rare. No similar cases have been reported in the literature, leaving a gap in guidance for managing this fracture type. We present the case of a 34-year-old female who came to the emergency department complaining of severe back pain after a traumatic injury. Initial pelvic radiographs were normal; however, a CT scan revealed minimally displaced complete bilateral avulsion fractures of the PSIS. Our approach was based on conservative management, focusing on pain control, and encouraging gradual resumption of physical activity. At the six-month follow-up, the patient showed significant clinical improvement and had returned to normal activities. Managing this case was challenging due to limited empirical data. However, opting for non-operative management yielded acceptable outcomes.